Green Surgery and Sustainability in Orthopaedic Operating Rooms: A Comprehensive Review of Environmental Initiatives.

Healthcare systems worldwide contribute significantly to environmental degradation through substantial carbon emissions and waste generation. Operating rooms, particularly orthopaedic theatres, are among the most resource-intensive areas within healthcare facilities. With the growing recognition of climate change as a major health threat, sustainability initiatives in perioperative care have become increasingly important. This narrative review examines current sustainability initiatives in orthopaedic operating rooms, evaluating strategies to reduce waste generation and environmental impact while maintaining patient care. A comprehensive literature review was conducted, examining peer-reviewed articles, systematic reviews, and policy documents related to environmental sustainability in operating rooms, with a specific focus on orthopaedic surgery. Sources included waste audit studies, carbon footprint analyses, and reports on green operating room initiatives published between 2013 and 2024. Sustainability initiatives in orthopaedic operating rooms can significantly reduce energy consumption and waste production. However, successful implementation faces challenges. Collaboration between different healthcare departments and sustainability multi-disciplinary team discussions are recommended for overcoming future challenges.