Radek Bartoška - Academia.edu (original) (raw)
Papers by Radek Bartoška
International Orthopaedics, Jul 28, 2011
Purpose Our aim was to assess operative treatment for post-traumatic avascular necrosis of the fe... more Purpose Our aim was to assess operative treatment for post-traumatic avascular necrosis of the femoral head (ANFH) in adolescents. Methods Eleven patients with an average age of 17 (range 14-26) years were operated up on for ANFH after proximal femoral fractures. The average interval between injury and reconstructive surgery was four (range two to eight) years. The average follow-up of the entire cohort was 89 (range 48-132) months. Five patients with total ANFH were treated by total hip replacement (THR). Six patients with partial ANFH were treated with valgus intertrochanteric osteotomy (VITO). Results In all patients, operation improved hip function. The average preoperative Harris Hip Score (HHS) was 70 points and average postoperative HHS was 97 points. Comparison of magnetic resonance imaging (MRI) scans before and after VITO demonstrated resorption of the necrotic segment of the femoral head and its remodelling in all six patients with partial ANFH. A complication was encountered in one patient. Conclusion Patients treated for ANFH had good mediumterm outcomes after THR for total necrosis and also after VITO for partial necrosis.
<p>One-year survival of patients with AF after non-cardiac surgery.</p
<p>Baseline characteristics of patients with AF according to (not) re-administration of asp... more <p>Baseline characteristics of patients with AF according to (not) re-administration of aspirin and VKA until hospital discharge.</p
<p>Re-administration of antithrombotic drugs according to surgery departments.</p
<p>Baseline characteristics of PRAGUE 14 study population according to presence of AF.</p
<p>Baseline characteristics of patients with AF according to preoperative usage of aspirin ... more <p>Baseline characteristics of patients with AF according to preoperative usage of aspirin vs VKA.</p
<p>One-year survival of patients on aspirin after non-cardiac surgery.</p
<p>Antithrombotic treatment re-administration in the period of up to 1 year after discharge... more <p>Antithrombotic treatment re-administration in the period of up to 1 year after discharge.</p
PloS one, 2017
The study investigated the discharge antithrombotic medication in patients with atrial fibrillati... more The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. Antithrombotics (interrupted due to surgery) were resumed until discharge in 51.8% of patients; less frequently in men (OR 0.6 (95% CI 0.95 to 0.35); p = 0.029), and in patients undergoing elective surgery (OR 0.6 (95% CI 0.91 to 0.33); p = 0.021). Dual antiplatelet therapy was resumed more often (91.7%) in comparison to aspirin monotherapy (57.3%; p = 0.047), and vitamin K antagonist (56.3%; p = 0.042). Patients with AF had significantly higher one-year mortality (22.1%) than patients without AF (14.1%, p = 0.001). The causes of death were: ischaemic events (32.6% of deaths),...
Injury, Jan 23, 2016
The most common cause of femoral fractures after osteosynthesis of trochanteric fractures with sh... more The most common cause of femoral fractures after osteosynthesis of trochanteric fractures with short nails is weakening of the femoral cortex via distal locking and stress concentrations at the tip of the nail. The aim of the study was to verify whether the incidence of peri-implant fractures is dependent upon the distal locking technique. We prospectively analysed a group of 849 pertrochanteric fractures (AO/ASIF 31-A1+2) managed with short nails from 2009 to 2013. Unlocked nailing was performed in 70.1% and distal dynamic locking was performed in 29.9%. The mean age was 82.0 years. Peri-implant fractures were divided into 3 groups according to the height of the fracture in relation to the tip of the nail. In total 17 fractures (2.0%) were detected. One peri-implant fracture occurred after locked nailing, whereas 16 cases occurred after unlocked nailing (p=0.037). Patients without distal locking had an 85.7% greater risk of peri-implant fracture. Fractures of the proximal femur (Ty...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2013
Nailing of pertrochanteric fractures is indicated when DHS is associated with high rate of compli... more Nailing of pertrochanteric fractures is indicated when DHS is associated with high rate of complications. Thus in unstable comminuted fractures, mainly with posterolateral defect and instability, with Adam´s arch defect and medial instability and in cases when fracture line extends into the subtrochanteric region. The increase in number of nailed pertrochanteric fractures has both its rational and irrational reasons; irrational, as until now there is no clear evidence, that nailing is a faster, safer and easier procedure with a lower rate of complications compared with DHS, a rational, as a proven increase in number of unstable and comminuted fractures has to be reflected in treatment changes. Thus, with respecting the operative techniques principles, intramedullary nailing provides evident biomechanical advantages with the possibility of full weight-bearing and a very low rate of complications.
International orthopaedics, Jan 8, 2015
The aim of this study was to evaluate a sample of patients who sustained hip fractures during the... more The aim of this study was to evaluate a sample of patients who sustained hip fractures during the years 1997-2011 and identify risk factors for a subsequent contralateral hip fracture; one-year mortality rates were compared in both groups. A total of 5,102 patients with hip fractures were prospectively studied to identify patients who had also suffered a subsequent, contralateral, hip fracture (SCHF). Those patients who had sustained a second fracture within 18 months of the initial fracture were then studied. All data were statistically processed. Within 18 months of the first fracture, a SCHF occurred in 105 patients (2.1 %). These patients were an average of three years older than those in the single fracture group. Risk factors for the development of a SCHF included: female gender, residing in a residential care facility, and limited mobility prior to injury. Trochanteric fractures did not represent a statistically significant risk factor for SCHF. More than three-quarters of pa...
Arteriosclerosis, Thrombosis, and Vascular Biology, 2015
Objective: To assess risks and predictors of ischemic/bleeding complications in consecutive patie... more Objective: To assess risks and predictors of ischemic/bleeding complications in consecutive patients with at least one cardiovascular disease undergoing elective major non-cardiac surgery. Methods: Subgroup analysis of the PRAGUE-14 study was performed. This prospective study analyzed the impact of antithrombotic therapy interruption on outcomes in non-selected surgical patients with known cardiovascular disease. Logistic regression models were applied to assess the association between potential predictors and selected binary coded end-points (perioperative ischemia, bleeding and hospital mortality). Results: Study population consisted of 1200 patients, 742 of them underwent elective surgery; age (median) 72.0, 66.2% males, CAD in 396, stroke in 70, atrial fibrillation in 209, venous thromboembolism (VTE) in 55, valvular heart disease in 108, artificial valve in 18, cardiomyopathy in 13. Preoperatively, 62.0% patients were receiving betablockers, 55.1% ACE inhibitors, 32.9% statins....
European Heart Journal, 2017
Risk estimation in high risk individuals 1125 prospective PCI registry (n=3831, since February 19... more Risk estimation in high risk individuals 1125 prospective PCI registry (n=3831, since February 1984 to February 2010). In the present study, cases with stable CAD, whose data of both baseline (at PCI) and follow-up (7.7 months after PCI in average) hs-CRP levels are available, were analyzed (n=877). Kaplan-Meier analysis showed lower survival rate in patients with higher hs-CRP at either baseline and follow-up (Figure A). However, univariate Cox regression analysis showed higher hazard ratios of high follow-up hs-CRP for cardiovascular death. Moreover, hazard ratio of high follow-up hs-CRP even with low baseline hs-CRP was substantially high (Figure B). Similarly, a multivariate analysis using Cox hazard model demonstrated that patients with persistent high hs-CRP had increased risk of cardiovascular mortality (HR: 1.63, 95% CI: 1.02-2.61, p=0.04). Figure 1 Conclusion: High hs-CRP level at chronic time point after PCI may offer a further important prognostic value in patients with stable CAD, compared to that at PCI.
Klinicka mikrobiologie a infekcni lekarstvi, 2007
PURPOSE Infection is considered one of the most serious complications of the surgical treatment o... more PURPOSE Infection is considered one of the most serious complications of the surgical treatment of musculoskeletal injuries. The aim of the study was to evaluate known risk factors and etiological agents of infectious complications in patients surgically treated for musculoskeletal injuries within 6 years. METHODS In a group of 5 234 patients followed in 2000-2005 the early or delayed infectious complication developed in 65 patients (26 women, 39 men, age 22-83 years). In every patient with infectious complication the important risk factors related to personal history, type of the injury, surgery and other treatment were recorded and microbiological culture results were collected. RESULTS In 60 patients (92.3%) at least one of the following risk factors was registered: diabetes mellitus, age above 75 years, abuse of alcohol and drugs, distant infectious focus or severe skin disease at the time of surgery, polytrauma requiring long-termed stay in intensive care unit, extensive soft t...
THE POSIBILITY OF COMPUTATIONAL MODELING USAGE IN THE SPECIFIC DYNAMIC HIP SCREW COMPLICATIONS AN... more THE POSIBILITY OF COMPUTATIONAL MODELING USAGE IN THE SPECIFIC DYNAMIC HIP SCREW COMPLICATIONS ANALYSIS. The aim of the study was to determine the relationship between the specific complications and the dynamic hip screw (DHS) placement in the femoral neck with relation to finite element method analysis. Th eimplant associated specific complications are very diverse. We evaluated 336 dynamic hip screw osteosyntheses for pertrochanteric fractures in 324 patients. The program ABAQUS 6.9 was utilized for the development of the finite element model of the femur. Analyses were performed in 5 modeled situations corresponding to the screw location. Complication rate within the group of patients was 10 % in general, with a reoperation rate of 4 %. The highest risk of for an implant failure was associated with a location of the screw in the upper third of the neck. The finite element model analysis confirms our clinical experiences, when the optimal placement for a dynamic hip screw is in th...
Injury-international Journal of The Care of The Injured, 2016
Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca, 2015
PURPOSE OF THE STUDY The aim of the study was to investigate the occurrence of avascular necrosis... more PURPOSE OF THE STUDY The aim of the study was to investigate the occurrence of avascular necrosis (AVN) of the femoral head following the osteosynthesis of intracapsular fracture of the femoral neck in relation to the time interval between injury and surgery and the type of fracture. MATERIAL AND METHODS The data of patients with intracapsular fractures of the femoral neck surgically treated in the period from 2001 to 2011 were reviewed. Of 1555 patients treated for this fracture, 125 (7%) underwent osteosynthesis. The evaluated group included 115 patients who came for examination at one-year follow-up. There were 59 (52%) women and 56 (48%) men. Dynamic hip screw (DHS) osteosynthesis with an anti-rotation screw was performed in 103 patients and lag-screw osteosynthesis involving three parallel cannulated cancellous screws was employed in 12 patients. The patients were allocated to groups according to the injury-to-surgery interval and to sub-groups on the basis of the Garden classi...
International Orthopaedics, Jul 28, 2011
Purpose Our aim was to assess operative treatment for post-traumatic avascular necrosis of the fe... more Purpose Our aim was to assess operative treatment for post-traumatic avascular necrosis of the femoral head (ANFH) in adolescents. Methods Eleven patients with an average age of 17 (range 14-26) years were operated up on for ANFH after proximal femoral fractures. The average interval between injury and reconstructive surgery was four (range two to eight) years. The average follow-up of the entire cohort was 89 (range 48-132) months. Five patients with total ANFH were treated by total hip replacement (THR). Six patients with partial ANFH were treated with valgus intertrochanteric osteotomy (VITO). Results In all patients, operation improved hip function. The average preoperative Harris Hip Score (HHS) was 70 points and average postoperative HHS was 97 points. Comparison of magnetic resonance imaging (MRI) scans before and after VITO demonstrated resorption of the necrotic segment of the femoral head and its remodelling in all six patients with partial ANFH. A complication was encountered in one patient. Conclusion Patients treated for ANFH had good mediumterm outcomes after THR for total necrosis and also after VITO for partial necrosis.
<p>One-year survival of patients with AF after non-cardiac surgery.</p
<p>Baseline characteristics of patients with AF according to (not) re-administration of asp... more <p>Baseline characteristics of patients with AF according to (not) re-administration of aspirin and VKA until hospital discharge.</p
<p>Re-administration of antithrombotic drugs according to surgery departments.</p
<p>Baseline characteristics of PRAGUE 14 study population according to presence of AF.</p
<p>Baseline characteristics of patients with AF according to preoperative usage of aspirin ... more <p>Baseline characteristics of patients with AF according to preoperative usage of aspirin vs VKA.</p
<p>One-year survival of patients on aspirin after non-cardiac surgery.</p
<p>Antithrombotic treatment re-administration in the period of up to 1 year after discharge... more <p>Antithrombotic treatment re-administration in the period of up to 1 year after discharge.</p
PloS one, 2017
The study investigated the discharge antithrombotic medication in patients with atrial fibrillati... more The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. Antithrombotics (interrupted due to surgery) were resumed until discharge in 51.8% of patients; less frequently in men (OR 0.6 (95% CI 0.95 to 0.35); p = 0.029), and in patients undergoing elective surgery (OR 0.6 (95% CI 0.91 to 0.33); p = 0.021). Dual antiplatelet therapy was resumed more often (91.7%) in comparison to aspirin monotherapy (57.3%; p = 0.047), and vitamin K antagonist (56.3%; p = 0.042). Patients with AF had significantly higher one-year mortality (22.1%) than patients without AF (14.1%, p = 0.001). The causes of death were: ischaemic events (32.6% of deaths),...
Injury, Jan 23, 2016
The most common cause of femoral fractures after osteosynthesis of trochanteric fractures with sh... more The most common cause of femoral fractures after osteosynthesis of trochanteric fractures with short nails is weakening of the femoral cortex via distal locking and stress concentrations at the tip of the nail. The aim of the study was to verify whether the incidence of peri-implant fractures is dependent upon the distal locking technique. We prospectively analysed a group of 849 pertrochanteric fractures (AO/ASIF 31-A1+2) managed with short nails from 2009 to 2013. Unlocked nailing was performed in 70.1% and distal dynamic locking was performed in 29.9%. The mean age was 82.0 years. Peri-implant fractures were divided into 3 groups according to the height of the fracture in relation to the tip of the nail. In total 17 fractures (2.0%) were detected. One peri-implant fracture occurred after locked nailing, whereas 16 cases occurred after unlocked nailing (p=0.037). Patients without distal locking had an 85.7% greater risk of peri-implant fracture. Fractures of the proximal femur (Ty...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2013
Nailing of pertrochanteric fractures is indicated when DHS is associated with high rate of compli... more Nailing of pertrochanteric fractures is indicated when DHS is associated with high rate of complications. Thus in unstable comminuted fractures, mainly with posterolateral defect and instability, with Adam´s arch defect and medial instability and in cases when fracture line extends into the subtrochanteric region. The increase in number of nailed pertrochanteric fractures has both its rational and irrational reasons; irrational, as until now there is no clear evidence, that nailing is a faster, safer and easier procedure with a lower rate of complications compared with DHS, a rational, as a proven increase in number of unstable and comminuted fractures has to be reflected in treatment changes. Thus, with respecting the operative techniques principles, intramedullary nailing provides evident biomechanical advantages with the possibility of full weight-bearing and a very low rate of complications.
International orthopaedics, Jan 8, 2015
The aim of this study was to evaluate a sample of patients who sustained hip fractures during the... more The aim of this study was to evaluate a sample of patients who sustained hip fractures during the years 1997-2011 and identify risk factors for a subsequent contralateral hip fracture; one-year mortality rates were compared in both groups. A total of 5,102 patients with hip fractures were prospectively studied to identify patients who had also suffered a subsequent, contralateral, hip fracture (SCHF). Those patients who had sustained a second fracture within 18 months of the initial fracture were then studied. All data were statistically processed. Within 18 months of the first fracture, a SCHF occurred in 105 patients (2.1 %). These patients were an average of three years older than those in the single fracture group. Risk factors for the development of a SCHF included: female gender, residing in a residential care facility, and limited mobility prior to injury. Trochanteric fractures did not represent a statistically significant risk factor for SCHF. More than three-quarters of pa...
Arteriosclerosis, Thrombosis, and Vascular Biology, 2015
Objective: To assess risks and predictors of ischemic/bleeding complications in consecutive patie... more Objective: To assess risks and predictors of ischemic/bleeding complications in consecutive patients with at least one cardiovascular disease undergoing elective major non-cardiac surgery. Methods: Subgroup analysis of the PRAGUE-14 study was performed. This prospective study analyzed the impact of antithrombotic therapy interruption on outcomes in non-selected surgical patients with known cardiovascular disease. Logistic regression models were applied to assess the association between potential predictors and selected binary coded end-points (perioperative ischemia, bleeding and hospital mortality). Results: Study population consisted of 1200 patients, 742 of them underwent elective surgery; age (median) 72.0, 66.2% males, CAD in 396, stroke in 70, atrial fibrillation in 209, venous thromboembolism (VTE) in 55, valvular heart disease in 108, artificial valve in 18, cardiomyopathy in 13. Preoperatively, 62.0% patients were receiving betablockers, 55.1% ACE inhibitors, 32.9% statins....
European Heart Journal, 2017
Risk estimation in high risk individuals 1125 prospective PCI registry (n=3831, since February 19... more Risk estimation in high risk individuals 1125 prospective PCI registry (n=3831, since February 1984 to February 2010). In the present study, cases with stable CAD, whose data of both baseline (at PCI) and follow-up (7.7 months after PCI in average) hs-CRP levels are available, were analyzed (n=877). Kaplan-Meier analysis showed lower survival rate in patients with higher hs-CRP at either baseline and follow-up (Figure A). However, univariate Cox regression analysis showed higher hazard ratios of high follow-up hs-CRP for cardiovascular death. Moreover, hazard ratio of high follow-up hs-CRP even with low baseline hs-CRP was substantially high (Figure B). Similarly, a multivariate analysis using Cox hazard model demonstrated that patients with persistent high hs-CRP had increased risk of cardiovascular mortality (HR: 1.63, 95% CI: 1.02-2.61, p=0.04). Figure 1 Conclusion: High hs-CRP level at chronic time point after PCI may offer a further important prognostic value in patients with stable CAD, compared to that at PCI.
Klinicka mikrobiologie a infekcni lekarstvi, 2007
PURPOSE Infection is considered one of the most serious complications of the surgical treatment o... more PURPOSE Infection is considered one of the most serious complications of the surgical treatment of musculoskeletal injuries. The aim of the study was to evaluate known risk factors and etiological agents of infectious complications in patients surgically treated for musculoskeletal injuries within 6 years. METHODS In a group of 5 234 patients followed in 2000-2005 the early or delayed infectious complication developed in 65 patients (26 women, 39 men, age 22-83 years). In every patient with infectious complication the important risk factors related to personal history, type of the injury, surgery and other treatment were recorded and microbiological culture results were collected. RESULTS In 60 patients (92.3%) at least one of the following risk factors was registered: diabetes mellitus, age above 75 years, abuse of alcohol and drugs, distant infectious focus or severe skin disease at the time of surgery, polytrauma requiring long-termed stay in intensive care unit, extensive soft t...
THE POSIBILITY OF COMPUTATIONAL MODELING USAGE IN THE SPECIFIC DYNAMIC HIP SCREW COMPLICATIONS AN... more THE POSIBILITY OF COMPUTATIONAL MODELING USAGE IN THE SPECIFIC DYNAMIC HIP SCREW COMPLICATIONS ANALYSIS. The aim of the study was to determine the relationship between the specific complications and the dynamic hip screw (DHS) placement in the femoral neck with relation to finite element method analysis. Th eimplant associated specific complications are very diverse. We evaluated 336 dynamic hip screw osteosyntheses for pertrochanteric fractures in 324 patients. The program ABAQUS 6.9 was utilized for the development of the finite element model of the femur. Analyses were performed in 5 modeled situations corresponding to the screw location. Complication rate within the group of patients was 10 % in general, with a reoperation rate of 4 %. The highest risk of for an implant failure was associated with a location of the screw in the upper third of the neck. The finite element model analysis confirms our clinical experiences, when the optimal placement for a dynamic hip screw is in th...
Injury-international Journal of The Care of The Injured, 2016
Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca, 2015
PURPOSE OF THE STUDY The aim of the study was to investigate the occurrence of avascular necrosis... more PURPOSE OF THE STUDY The aim of the study was to investigate the occurrence of avascular necrosis (AVN) of the femoral head following the osteosynthesis of intracapsular fracture of the femoral neck in relation to the time interval between injury and surgery and the type of fracture. MATERIAL AND METHODS The data of patients with intracapsular fractures of the femoral neck surgically treated in the period from 2001 to 2011 were reviewed. Of 1555 patients treated for this fracture, 125 (7%) underwent osteosynthesis. The evaluated group included 115 patients who came for examination at one-year follow-up. There were 59 (52%) women and 56 (48%) men. Dynamic hip screw (DHS) osteosynthesis with an anti-rotation screw was performed in 103 patients and lag-screw osteosynthesis involving three parallel cannulated cancellous screws was employed in 12 patients. The patients were allocated to groups according to the injury-to-surgery interval and to sub-groups on the basis of the Garden classi...