Implant waste occurred in 37 of 6531 procedures (0.6%) with 16 of the centers (21.6%) reporting at least one occurrence and 95% attributed to the surgeon or operating room staff. Community hospitals were found to have a significantly higher incidence of implant waste as compared with teaching hospitals. Hospitals absorbed 74% of the wasted implant costs ($20,357 over the study period). This expense represented a mean additional cost of $3.12 per orthopaedic trauma procedure performed.