Sustainable orthopaedics: the needs and challenges

Climate change is undoubtedly a global threat, with extreme weather events, air pollution, and food insecurity disproportionately impacting low-income countries. The healthcare sector, whilst responsible for 4.4% of global net carbon emissions, has been slow in addressing its environmental footprint. This article explores the needs and challenges to achieve sustainable orthopaedic surgery. Orthopaedic surgery continues to create a large carbon footprint, primarily through the use of single-use consumables and energy-intensive operating theatres. While efforts to reduce environmental harm have primarily targeted changes within the operating theatre, a comprehensive approach must consider the entire surgical pathway. The principles of reduce, reuse and recycle are paramount. Reducing surgical caseload and advancing digital healthcare afford opportunities to streamline patient interactions, reduce travel emissions and improve efficiency. Furthermore, reevaluating routine practices, such as preoperative investigations and postoperative care, can minimize unnecessary resource consumption. Improving the sustainability of orthopaedics will bring conflicting clinical, financial and environmental challenges. However, with increasing awareness among healthcare professionals and support from it's professional bodies, there is growing momentum toward sustainable orthopaedic surgery. Transitioning to sustainable orthopaedic surgery neccesitates a broad approach encompassing prevention, optimization, and streamlining of the surgical pathway. Addressing environmental concerns alongside clinical outcomes is imperative for the future of orthopaedic surgery.