Our Impact on Global Warming: A Carbon Footprint Analysis of Orthopaedic Operations.

Background: The health-care sector and particularly the surgical sector are major contributors to the exacerbation of the global climate crisis. Little is known about the carbon emissions caused by surgical procedures. Therefore, the aim of this study was to estimate the carbon footprint associated with common orthopaedic surgical procedures.

Methods: Eight surgical procedures (total hip arthroplasty, total knee arthroplasty, knee arthroscopy, anterior cruciate ligament reconstruction, shoulder arthroscopy, elective foot surgery, revision hip arthroplasty, and revision knee arthroplasty) were selected for analysis. The inventory process was performed according to the Greenhouse Gas Protocol for all activity occurring in the operating room.

Results: The carbon footprint (in CO2 equivalents, CO2e) ranged between 53.5 kg for knee arthroscopy and 125.9 kg for revision knee arthroplasty. Energy consumption accounted for 57.5% of all emissions, followed by other indirect emissions (38.8%) and direct emissions (3.7%). The largest single contributors were the supply chain (34.6%) and energy consumption for ventilation, heating, and air conditioning (32.7%).

Conclusions: Orthopaedic surgical procedures produce considerable amounts of CO2. Reduction in and greening of energy consumption, as well as the decarbonization of the supply chain, would have the greatest impact in reducing the carbon footprint of orthopaedic surgical procedures.

Clinical relevance: Orthopaedic surgical procedures contribute to the climate crisis by emitting relevant amounts of CO2. It should therefore be imperative for all orthopaedic surgeons to endeavor to find solutions to mitigate the environmental impact of their practice.