One patient may undergo several procedures, such bilateral or staged hip replacement which counts as 2 procedures.
Dystrophin and its associated glycoproteins are believed to provide mechanical stability during muscle contraction; hence its deficiency is postulated to result in fragility of the sarcolemma and subsequently necrosis and, in later stages, replacement of muscle by fibrous tissue.
One-stage replacement was associated with a better outcome than that of other surgical procedures, including 2-stage replacement.
The favorable conditions required for 1-stage replacement may explain the good results observed in our patients who underwent this surgical procedure.
In conclusion, the theme of this article is to share a successful one-stage replacement of infected breast prosthesis by atypical NTM after mastectomy reconstruction.
Out of the six late infections published ([ 7- 12] case No.4), one-stage replacement was described in only one case [ 7], who was unsuccessfully pretreated with co-trimoxazole for 16 months before implant-replacement.
For 34 patients who underwent 2-stage surgical procedures (ie, 2-stage replacement and arthrodesis), a gentamicin-loaded cement spacer was implanted for a mean time between initial and second intervention of 116.6 ± 14.9 days (range, 26 395 days).
There has been only a single one-stage replacement in the literature, after Salmonella infection, but in that case, this was preceded by more than a year-long antibiotic treatment [ 7].
A spacer was used in patients treated with 2-stage replacement of the prosthesis, even in case of methicillin-resistant S. aureus (MRSA) infection, which was the only situation that differed from the recommendations of Zimmerli et al [ 1].
For 2-stage procedures (ie, 2-stage replacement and arthrodesis), reimplantation was performed after an antibiotic treatment duration of ≥12 weeks with or without an additional antibiotic-free period of 4 weeks and if the C-reactive protein value had normalized (<10 mg/L), except when chronic inflammatory disease interfered with C-reactive protein values.
