Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius-Maximilians University Wuerzburg, Wuerzburg, Germany.
Department of Musculoskeletal Tissue Regeneration, Koenig-Ludwig-Haus, Julius-Maximilians University Wuerzburg, Wuerzburg, Germany.
J Bone Joint Surg Am. 2024 Nov 6;106(21):1971-1977. doi: 10.2106/JBJS.24.00212. Epub 2024 Sep 19.
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.
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.
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%).
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.
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.
医疗保健行业，尤其是外科领域，是全球气候危机恶化的主要贡献者。人们对手术过程产生的碳排放知之甚少。因此，本研究旨在评估常见骨科手术相关的碳足迹。
选择了 8 种外科手术（全髋关节置换术、全膝关节置换术、膝关节镜检查、前交叉韧带重建术、肩关节镜检查、择期足部手术、髋关节翻修术和膝关节翻修术）进行分析。根据温室气体协议，对手术室中发生的所有活动进行清单编制过程。
碳足迹（以二氧化碳当量，CO2e 表示）范围从膝关节镜检查的 53.5kg 到膝关节翻修术的 125.9kg。能源消耗占所有排放的 57.5%，其次是其他间接排放（38.8%）和直接排放（3.7%）。最大的单一贡献者是供应链（34.6%）和通风、供暖和空调的能源消耗（32.7%）。
骨科手术会产生大量的 CO2。减少和绿化能源消耗，以及供应链的脱碳，将对减少骨科手术的碳足迹产生最大影响。
骨科手术通过排放相关数量的 CO2 对气候危机做出贡献。因此，所有骨科医生都应该努力寻找解决方案，以减轻其实践对环境的影响。
