Investigation of Intraoperative Bacterial Contamination in Surgical Instruments Used for Total Hip Arthroplasty

Reusing surgical instruments during simultaneous bilateral total hip arthroplasty (THA) may reduce direct costs but may increase the risk of periprosthetic joint infections, particularly through femoral broaches used for canal preparation. This study investigated potential bacterial contamination of surgical instruments to assess the safety of their reuse.

Seventy-eight primary THA cases (15 males, 63 females; mean age, 63.8 ± 11.2 years) performed between January 2021 and October 2022 were analyzed. This prospective study evaluated bacterial contamination of the femoral broach during THA. In cases of simultaneous bilateral procedures, sampling was conducted after completion of the first-operated side. Patients were categorized according to operative duration (<90 minutes vs ≥ 90 minutes) using a predefined cutoff based on previous literature. Additional comparisons were made between culture-positive and culture-negative groups.

Bacterial contamination was detected in 3 cases (3.8%), all involving skin commensals (Staphylococcus capitis or Micrococcus luteus), with no periprosthetic joint infections reported. All positive cultures occurred in the short-time group. Operative time showed no association with contamination, whereas body weight and body mass index were significantly higher among culture-positive patients.

Although no clinically significant infections occurred, bacterial contamination of surgery instruments was observed. Reusing a single instrument set may be safe with strict infection control measures; however, additional vigilance is warranted for obese patients due to their higher contamination risk.