The intraoperative appearance of rapidly destructive osteoarthritis and septic arthritis can be similar. Three patients at our institution demonstrated preoperative or intraoperative findings potentially consistent with infection during primary total hip arthroplasty; however, none of these patients were found to have an actual infection. One of these patients underwent an unnecessary 2-stage total hip arthroplasty secondary to the intraoperative appearance of their joint fluid. We advocate performing an infection workup preoperatively when patients present with rapid degenerative changes of their hip joint to diminish the uncertainty of proceeding with arthroplasty.