Environmental impact of NanoNeedle arthroscopy versus conventional knee arthroscopy: a hybrid carbon footprint analysis.

Authors

Evan Argintar, Chiara-Maria Homann, Rosie Hillson, Ingeborg Steinbach, Christopher W Gee, Stephen Rossettie, Alex Burnett, Richard Wigham

Published in

BMJ open. Volume 16. Issue 8. Pages e119428. Aug 31, 2026. Epub Aug 31, 2026.

Abstract

To evaluate greenhouse gas (GHG) emissions from procedure room NanoNeedle arthroscopy (NA) and its associated clinical pathway, compared with conventional arthroscopy (CA) delivered in an operating room, focusing on non-complex knee arthroscopy procedures.
Hybrid carbon footprint analysis using process-based life-cycle methods combined with economy-wide input-output data that include environmental impact factors for medical devices and components of patient care pathways. Three care pathways were evaluated: (1) CA in an OR with preoperative MRI, (2) NA in a procedure room with MRI and (3) NA in a procedure room without MRI. Emissions were calculated for all pathway components, including patient and staff travel, diagnostic imaging, medical devices, the procedure itself and postoperative care.
UK National Health Service-based care pathway model for non-complex knee arthroscopy procedures.
The primary outcome was GHG emissions (kgCO₂e) per procedure pathway. Additional analyses assessed emissions by pathway component, adoption scenarios, conversion rates from NA to CA and sensitivity analyses for selected assumptions and input parameters.
The CA pathway generated 77.0 kgCO_₂e per procedure, whereas the NA with MRI produced 45.0 kgCO₂e and NA without MRI 35.3 kgCO₂e, representing reductions of 42% and 54% of kgCO₂e, respectively. Major emission contributors for CA were patient travel, consumable items and general anaesthesia; for NA pathways, patient travel and the device itself were the leading contributors. Adoption modelling indicated that using NA without MRI for 5000-20 000 knee arthroscopy procedures could yield annual CO₂e savings ranging from 208 tons to 834 tons.
Knee arthroscopy delivered via the NA procedure room pathway has the potential to substantially reduce environmental impact compared with conventional OR-based care. As healthcare providers and policymakers increasingly consider environmental sustainability, technologies that enable alternative care models, such as NA in a procedure room setting, may represent a promising approach for reducing the carbon footprint of selected procedures.

PMID:
42674801
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.

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