Climate change and the operating room: perceptions of orthopaedic surgeons on environmental sustainability

Purpose Orthopaedic surgery has a significant environmental impact, yet limited research has explored the perspectives of orthopaedic surgeons and trainees regarding operating room (OR) sustainability. The OR contributes extensively to healthcare waste, energy consumption and greenhouse gas emissions, underscoring the need for innovative solutions to address these challenges. The purpose of this study is to assess current sustainable OR practices, attitudes and barriers to sustainability within orthopaedic surgery. Methods A 36-question survey addressing demographics, climate beliefs, OR sustainability attitudes, practice patterns and educational exposure was distributed across five US orthopaedic surgery programmes. Responses were analysed using χ² and analysis of variance tests to evaluate differences by age group, training level, fellowship type and geographic region. Results 92 participants completed the survey. While almost all respondents (98.9%) believed climate change is occurring, fewer believed human actions can meaningfully alter its course (64.4%) or that OR waste is a major contributor to the crisis (46.0%). Most respondents (79%) considered reusing single-use devices, but less than 3% factored in life cycle assessments when making decisions, and only 21% considered environmental impact when ordering imaging. Although respondents identified significant opportunities to reduce OR waste and improve environmentally friendly practices at their institutions, few expressed satisfaction with current efforts, and 79% were unaware of any existing plans for improvement. Barriers included lack of incentives (79%), cost (62.9%) and insufficient knowledge (62.9%). Notably, respondents emphasised the need for formal education on sustainability within orthopaedic training programmes. Conclusion Orthopaedic surgeons and trainees recognise the need for better OR sustainability practices but face systemic barriers to progress. Addressing these gaps through institutional support, cost-effective strategies and targeted education could significantly reduce environmental impacts in orthopaedic surgery.