Abstract
OBJECTIVES: The United States (US) healthcare sector contributes to 8.5% of the nation’s carbon emissions. Reducing the carbon footprint of resource-intensive environments, such as operating rooms (OR), is essential for achieving net-zero carbon emissions in healthcare. Arthroscopic partial meniscectomy (APM) is the most commonly performed orthopaedic procedure in the US. This study aimed to quantify the carbon dioxide equivalent emissions associated with a standard knee arthroscopy procedure. METHODS: The carbon footprint, measured in kilograms of carbon dioxide equivalents (kgCO2e), was used to estimate environmental impact. Measurements and energy usage were derived from the outpatient surgery at our institution. The carbon footprint for a standard APM procedure was calculated based on an average surgery time of 45 minutes in an OR measured at 528sq ft. Calculating OR energy usage took into account the lighting, heating, ventilation, and air-conditioning (HVAC) systems, anesthesia gases and equipment, arthroscopy equipment and sterilization processes (assuming 1.5 hours processing time and 3 specialty trays per case). Waste generated after each case was weighed and averaged. Standard conversions outlined by the US Environmental Protection Agency were used - 0.417kgCO2 per kWh and 3.5kgCO2 per 1kg of US landfill waste. RESULTS: The carbon footprint on average of one APM was 46.2kgCO2e, equivalent to driving a gasoline-powered car for 118 miles. The largest contributor, accounting for 81.3% (37.6kgCO2e) of the carbon footprint was the waste generated during the procedure, followed by anesthesia, HVAC, arthroscopy tower, lighting, and sterilization (Table 1). With over 500,000 APMs performed annually in the US, this amounts to 23,100 metric tons CO2e, equivalent to the annual electricity use of 4559 homes. CONCLUSIONS: Environmental sustainability in orthopaedic surgery is an increasing area of interest. Understanding the environmental impact of commonly performed procedures is the first step toward reducing the carbon footprint of our healthcare ecosystem. The substantial carbon emissions from waste during these procedures underscore the need for optimizing waste disposal processes, increasing recycling and switching to reusables, to reduce the overall carbon footprint.