What did the study look at?
The authors note that healthcare generates 4%-5% of global greenhouse gas emissions, and that orthopaedic surgery is a major source because of energy-intensive equipment and high use of disposable materials. Such calculations have been made for knee and hip replacement, but the environmental burden of hip arthroscopy (keyhole surgery on the hip joint using a camera) had not been examined.
The study aimed to measure the patient-level carbon footprint of hip arthroscopy in athletically active, non-professional patients, to identify what drives it, and to examine how it relates to functional outcomes after surgery.
How was it done?
This was a retrospective cohort study. It included 58 patients who had a first hip arthroscopy for femoroacetabular impingement (bony shapes that pinch the hip joint) between March 2023 and March 2025 at a single tertiary centre.
- Carbon emissions (kg CO₂ equivalent) were calculated for each patient across six areas: operating theatre energy, surgical materials, sterilisation, anaesthesia, patient travel and waste management.
- Functional outcomes were assessed at 12 months with the iHOT-12 and the Hip Outcome Score (daily living and sport subscales).
- Multivariable regression was used to identify independent predictors of the total carbon footprint and of a measure the authors call "carbon efficiency".
What did it find?
- The mean total carbon footprint was 75.14 ± 24.18 kg CO₂ equivalent per patient.
- The largest contributors were travel (52.9%) and surgical materials (29.6%).
- Patient travel distance, operating time and number of hospital visits were significant predictors of the total footprint; together the model explained 77.7% of its variation.
- Material-related emissions differed significantly between patients who received two anchors and those who received three or more. However, the two-anchor group contained only four patients, and the authors stress that this finding is hypothesis-generating only.
- Patients with higher iHOT-12 scores before surgery had better carbon efficiency, while revision surgery was linked with poorer efficiency. The authors state that this association should be read as descriptive rather than causal.
The authors' conclusion
The authors conclude that in this exploratory, single-centre study the carbon footprint of hip arthroscopy was driven mainly by patient travel and surgical materials. The findings suggest that better travel planning, operative efficiency and material selection may reduce environmental impact without compromising clinical outcomes. They stress that this needs to be confirmed in larger, multicentre cohorts.
Limitations
- The study was exploratory and carried out at a single centre; the results need validation in larger, multicentre cohorts.
- It used a retrospective design.
- In the comparison by anchor number, the two-anchor group contained only four patients.
- The associations with carbon efficiency are descriptive, not causal.
Note: because the full text could not be accessed, this summary is based on the published abstract and highlights.
Reference
Özdemir E, Altay N, Topsakal FE, Şahbat Y, Gürsoy S. (2026). Carbon footprint of hip arthroscopy in non-professional athletically active patients: a patient-level analysis of surgical variables, anesthesia type, and functional outcomes. Journal of Hip Preservation Surgery, hnag035. Licence: CC BY 4.0.
DOI: 10.1093/jhps/hnag035
Free full text: Journal of Hip Preservation Surgery (Oxford University Press)
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
