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Al-Amiry, Bariq
Alternative names
Publications (6 of 6) Show all publications
Al-Amiry, B., Pantelakis, G., Mahmood, S., Kadum, B., Brismar, T. B. & Sayed-Noor, A. S. (2019). Does body mass index affect restoration of femoral offset, leg length and cup positioning after total hip arthroplasty?: a prospective cohort study. BMC Musculoskeletal Disorders, 20, Article ID 422.
Open this publication in new window or tab >>Does body mass index affect restoration of femoral offset, leg length and cup positioning after total hip arthroplasty?: a prospective cohort study
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2019 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 20, article id 422Article in journal (Refereed) Published
Abstract [en]

Background: In obese patients, total hip arthroplasty (THA) can be technically demanding with increased perioperative risks. The aim of this prospective cohort study is to evaluate the effect of body mass index (BMI) on radiological restoration of femoral offset (FO) and leg length as well as acetabular cup positioning.

Methods: In this prospective study, patients with unilateral primary osteoarthritis (OA) treated with THA between September 2010 and December 2013 were considered for inclusion. The perioperative plain radiographs were standardised and used to measure the preoperative degree of hip osteoarthritis, postoperative FO, leg length discrepancy (LLD), acetabular component inclination and anteversion.

Results: We included 213 patients (74.5% of those considered for inclusion) with a mean BMI of 27.7 (SD 4.5) in the final analysis. The postoperative FO was improper in 55% and the LLD in 15%, while the cup inclination and anteversion were improper in 13 and 23% of patients respectively. A multivariable logistic regression model identified BMI as the only factor that affected LLD. Increased BMI increased the risk of LLD (OR 1.14, 95% CI 1.04 to 1.25). No other factors included in the model affected any of the primary or secondary outcomes.

Conclusion: Increased BMI showed a negative effect on restoration of post-THA leg length but not on restoration of FO or positioning of the acetabular cup. Age, gender, OA duration or radiological severity and surgeon’s experience showed no relation to post-THA restoration of FO, leg length or cup positioning.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2019
Keywords
BMI, Hip arthroplasty, Femoral offset, Leg length discrepancy, Cup positioning
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-151712 (URN)10.1186/s12891-019-2790-y (DOI)000485277400001 ()31510993 (PubMedID)2-s2.0-85072113263 (Scopus ID)
Available from: 2018-09-10 Created: 2018-09-10 Last updated: 2024-03-04Bibliographically approved
Al-Amiry, B. (2018). Radiological measurements in total hip arthroplasty. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Radiological measurements in total hip arthroplasty
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Every year, about 1 million patients worldwide and 20000 patients in Sweden undergo total hip arthroplasty (THA). This type of operation is considered a successful, safe and cost-effective procedure to regain mobility and restore hip joint function in patients suffering from severe hip joint disease or trauma. The main goals of the operation are to relief the pain, improve quality of life (QoL) and to restore the biomechanical forces around the hip with appropriate femoral offset (FO), leg length and proper component position and orientation. The radiographic preoperative planning and postoperative evaluation of these parameters require good validity, interobserver reliability and intraobserver reproducibility. Most patients are satisfied after THA, although this treatment still has its complications. About 10 % of THA patients report persistent pain and suboptimal functional outcome and QoL at long-term follow-up. The absolute number of dissatisfied patients is expected to rise given the increase in the annual number of THA performed. Therefore, every effort should be made to investigate factors that possibly influence THA outcome. The data available about the influence of preoperative radiological severity and symptom duration of OA on the outcome of THA are scarce and contradictory. Further studies even needed to evaluate the effect of obesity on post-operative THA radiological measurements

Abstract [sv]

Varje år opereras ungefär 1 miljon patienter runt om i världen och 20,000 patienter i Sverige med en total höftledsprotes (THA). Höftledsprotesoperation anses vara en av de mest framgångsrika, säkra och kostnadseffektiva kirurgiska åtgärderna med ett syfte att smärtlindra, återställa rörligheten och förbättra livskvaliteten. Höftleden drabbas av artros, åldersrelaterad sjukdom som orsakar destruktion av leden. Vid operation med THA är det viktigt att återställa de biomekaniska krafterna runt höftleden med en adekvat så kallad femoral offset (FO), avståndet mellan höftens rörelsecentrum och mitten av bäckenet, postoperativ benlängdsskillnad (BLS) och ett tillfredsställande komponentläge. Den preoperativa planeringen och den postoperativa röntgenbedömningen av dessa parametrar kräver god tillförlitlighet, det vill säga validitet och reproducerbarhet både mellan olika bedömare och vid upprepade mätningar av samma bedömare. Således är radiologiska mätningar före och efter THA oerhört viktiga för att få bästa resultat efter THA. Det finns inte tillräckligt med information i litteraturen om effekten av den preoperativa radiologiska artrosgraden och symptomduration av artrosen på utfallet av THA. Dessutom behövs ytterligare forskning för att studera effekten av obesitas på de radiologiska mätningarna efter THA.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 69
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1983
Keywords
Total hip arthroplasty, leg length discrepancy, femoral offset, WOMAC, quality of life, radiographicmeasurements, Kellgren-Lawrence, duration, acetabular cup, inclination, anteversion, BMI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-151862 (URN)978-91-7601-943-6 (ISBN)
Public defence
2018-10-12, Lionsalen, byggnad 7, målpunkt Y22, 2 tr, Umeå universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-09-21 Created: 2018-09-14 Last updated: 2018-11-08Bibliographically approved
Al-Amiry, B. S., Gaber, J. F., Kadum, B. K., Brismar, T. B. & Sayed-Noor, A. S. (2018). The Influence of Radiological Severity and Symptom Duration of Osteoarthritis on Postoperative Outcome After Total Hip Arthroplasty: A Prospective Cohort Study. The Journal of Arthroplasty, 33(2), 436-440
Open this publication in new window or tab >>The Influence of Radiological Severity and Symptom Duration of Osteoarthritis on Postoperative Outcome After Total Hip Arthroplasty: A Prospective Cohort Study
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2018 (English)In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 33, no 2, p. 436-440Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to investigate the influence of preoperative radiological severity and symptom duration of hip osteoarthritis (OA) on the postoperative functional outcome, quality of life, as well as abductor muscle strength after total hip arthroplasty (THA). Methods: In this prospective cohort study, we studied 250 patients. Preoperatively, we evaluated the function with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life with euroqol-5D (EQ-5D). At 1 year after THA, the same scores and also hip abductor muscle strength were measured in 222 patients. We divided the cohort twice, first according to the radiological OA severity [Kellgren-Lawrence classification (KL)] and then according to the OA symptom duration. We investigated whether the preoperative KL class and symptom duration influenced the 1-year WOMAC (primary outcome measure) or EQ-5D and abductor muscle strength (secondary outcome measures). Results: The crude results showed that KL class and symptom duration had no influence (P = .90 and P = .20, respectively) on the 1-yearWOMAC. Younger age, male gender, and lower body mass index were associated with a better function. Regarding 1-year EQ-5D, the crude results showed that body mass index and KL class had no influence (P = .83 and P = .39, respectively). The adjusted results showed that only age and gender influenced the postoperative EQ-5D. No influence of the tested factors was found on the 1-year abductor muscle strength. Conclusion: Preoperative radiological OA severity and symptom duration had no influence on the outcome of THA and should probably not affect the decision about timing the operative intervention. 

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2018
Keywords
radiological severity, symptom duration, hip osteoarthritis, postoperative outcome, total hip throplasty
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-145155 (URN)10.1016/j.arth.2017.09.051 (DOI)000424145000022 ()29066249 (PubMedID)2-s2.0-85045291303 (Scopus ID)
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2023-03-24Bibliographically approved
Al-Amiry, B., Mahmood, S., Krupic, F. & Sayed-Noor, A. (2017). Leg lengthening and femoral-offset reduction after total hip arthroplasty: where is the problem - stem or cup positioning?. Acta Radiologica, 58(9), 1125-1131, Article ID 0284185116684676.
Open this publication in new window or tab >>Leg lengthening and femoral-offset reduction after total hip arthroplasty: where is the problem - stem or cup positioning?
2017 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 58, no 9, p. 1125-1131, article id 0284185116684676Article in journal (Refereed) Published
Abstract [en]

Background: Restoration of femoral offset (FO) and leg length is an important goal in total hip arthroplasty (THA) as it improves functional outcome. Purpose: To analyze whether the problem of postoperative leg lengthening and FO reduction is related to the femoral stem or acetabular cup positioning or both. Material and Methods: Between September 2010 and April 2013, 172 patients with unilateral primary osteoarthritis treated with THA were included. Postoperative leg-length discrepancy (LLD) and global FO (summation of cup and FO) were measured by two observers using a standardized protocol for evaluation of antero-posterior plain hip radiographs. Patients with postoperative leg lengthening >= 10mm (n = 41) or with reduced global FO >5mm (n = 58) were further studied by comparing the stem and cup length of the operated side with the contralateral side in the lengthening group, and by comparing the stem and cup offset of the operated side with the contralateral side in the FO reduction group. We evaluated also the inter-observer and intra-observer reliability of the radiological measurements. Results: Both observers found that leg lengthening was related to the stem positioning while FO reduction was related to the positioning of both the femoral stem and acetabular cup. Both inter-observer reliability and intra-observer reproducibility were moderate to excellent (intra-class correlation co-efficient, ICC >= 0.69). Conclusion: Post THA leg lengthening was mainly caused by improper femoral stem positioning while global FO reduction resulted from improper positioning of both the femoral stem and the acetabular cup.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Hip arthroplasty, leg length discrepancy, femoral offset, plain radiographs, reliability
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-138202 (URN)10.1177/0284185116684676 (DOI)000405779200013 ()2-s2.0-85025098047 (Scopus ID)
Note

Originally included in thesis in manuscript form with title Leg lengthening and femoral offset reduction after total hip arthroplasty: where is the problem located – stem or cup?

Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2023-03-24Bibliographically approved
Mahmood, S. S., Al-Amiry, B., Mukka, S. S., Baea, S. & Sayed-Noor, A. S. (2015). Validity, reliability and reproducibility of plain radiographic measurements after total hip arthroplasty. Skeletal Radiology, 44(3), 345-351
Open this publication in new window or tab >>Validity, reliability and reproducibility of plain radiographic measurements after total hip arthroplasty
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2015 (English)In: Skeletal Radiology, ISSN 0364-2348, E-ISSN 1432-2161, Vol. 44, no 3, p. 345-351Article in journal (Refereed) Published
Abstract [en]

In total hip arthroplasty (THA), radiographic preoperative planning and postoperative evaluation of acetabular component, femoral offset (FO) and leg length discrepancy (LLD) require good validity, interobserver reliability and intraobserver reproducibility. In this study, we evaluated the validity of the Sundsvall method of FO measurement and the interobserver reliability and intraobserver reproducibility of measurement of FO, LLD, acetabular cup inclination and anteversion. Ninety patients with primary unilateral osteoarthritis (OA) were included in this prospective study. On postoperative radiographs FO by the Sundsvall method (femoral axis-pelvic midline), FO by a standard method (femoral axis-hip rotational centre-teardrop point), LLD (inter-teardrop line-lesser trochanter), acetabular cup inclination (on AP view the angle between the cup rim and transischial line) and anteversion (on lateral view the angle between the face of acetabulum and a line perpendicular to the horizontal plane) were measured. The interobserver reliability and intraobserver reproducibility were calculated for three independent observers. The concurrent validity and degree of prediction of the Sundsvall method are measured by comparing its results with the standard method. The interobserver reliability of all measurements was excellent (ICC > 0.80), except for LLD, which was substantial (ICC = 0.79). The intraobserver reproducibility of all measurements was excellent (ICC > 0.80). The concurrent validity of the Sundsvall method compared to the standard method was good with a positive correlation. The Sundsvall method is as reliable as the standard method. The evaluated radiographic measurement methods have the required validity and reliability to be used in clinical practice.

Place, publisher, year, edition, pages
Springer, 2015
Keywords
Radiographic measurements, Total hip arthroplasty, Leg length discrepancy, Femoral offset, etabular cup, Inclination, Anteversion
National Category
Surgery Orthopaedics Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-100945 (URN)10.1007/s00256-014-2055-7 (DOI)000348925400005 ()25403426 (PubMedID)2-s2.0-84925490420 (Scopus ID)
Available from: 2015-03-20 Created: 2015-03-16 Last updated: 2023-03-24Bibliographically approved
Kjellberg, M., Al-Amiry, B., Englund, E., Sjödén, G. O. & Sayed-Noor, A. S. (2012). Measurement of leg length discrepancy after total hip arthroplasty: the reliability of a plain radiographic method compared to CT-scanogram. Skeletal Radiology, 41(2), 187-191
Open this publication in new window or tab >>Measurement of leg length discrepancy after total hip arthroplasty: the reliability of a plain radiographic method compared to CT-scanogram
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2012 (English)In: Skeletal Radiology, ISSN 0364-2348, E-ISSN 1432-2161, Vol. 41, no 2, p. 187-191Article in journal (Refereed) Published
Abstract [en]

To measure the interobserver reliability and intraobserver reproducibility of post total hip arthroplasty (THA) leg length discrepancy (LLD) measurement on radiographs as well as to evaluate its accuracy by comparing it with LLD measurement on computed tomographic scanogram (CT-scanogram). In this prospective study, postoperative LLD measurements in ten THA patients were made by four observers on anteroposterior radiographs of the pelvis (inter-teardrop line to the tip of lesser trochanter) and compared to LLD measurements made on CT-scanogram scout views of the lower limb. Two observers repeated the LLD measurements on radiographs 8 weeks after the first measurements. The interobserver reliability of the LLD measurement on plain radiographs was evaluated by comparing the measurements of the four observers and the intraobserver reproducibility by comparing the two repeated measurements made by the two observers. We found excellent interobserver reliability (mean ICC 0.83) and intraobserver reproducibility (ICC 0.90 and 0.88) of the LLD measurements on plain radiographs. There was a moderate to excellent agreement, but with wide variation of measurements among the four observers, when plain radiographic measurement was compared with CT-scanogram (ICC 0.58, 0.60, 0.71, and 0.82). Despite the excellent interobserver reliability and intraobserver reproducibility of LLD measurement on radiographs, clinicians should be aware of its limited accuracy when compared to CT-scanogram.

Place, publisher, year, edition, pages
Springer London, 2012
Keywords
Leg length discrepancy, Interobserver reliability, Intraobserver reproducibility, Radiographs, CT-scanogram
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-51449 (URN)10.1007/s00256-011-1166-7 (DOI)000298357500010 ()2-s2.0-84856968574 (Scopus ID)
Available from: 2012-01-25 Created: 2012-01-23 Last updated: 2023-03-23Bibliographically approved
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