Prevalence of Infection in Bilateral Total Hip Arthroplasty: A Comparison of Single-Stage 565 Bilateral Procedures Performed with 1 or 2 Sets of Instruments

Single-stage bilateral total hip arthroplasty can be performed with a completely new sterile setup for the second side or with the same instruments for both sides. The latter could theoretically lead to a higher prevalence of infection in the second side. We retrospectively determined the prevalence of deep infection during the first postoperative year in 271 consecutive patients operated on with different sterile setups (group 1) and 289 patients operated on with the same setup (group 2). There was one deep infection affecting the first side of a patient in group 1. In group 2, there were no deep infections (P ∼ 1.0) and one developed a superficial infection on the second side requiring readmission and intravenous antibiotics. Given the very low prevalence of deep infection of the first and second side (0.2% and 0%, respectively), it would be necessary to analyze more than 2300 patients in each group to achieve statistical significance. Based on this experience, the use of the same set of instruments for the second side in the operating conditions described in this study appears safe.