{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:23:01Z","timestamp":1788009781636,"version":"build-2784847793"},"reference-count":39,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Revision total hip arthroplasty (rTHA) presents significant challenges, particularly in patients with severe acetabular bone defects. Traditional treatment options often fall short, leading to the emergence of custom-made 3D-printed acetabular implants. Accurate assessment of implant positioning is crucial for ensuring optimal postoperative outcomes and for providing feedback to the surgical team. This single-center, retrospective cohort study evaluates the accuracy of standard 2D radiographs versus 3D CT scans in assessing the positioning of these implants, aiming to determine if 2D imaging could serve as a viable alternative for the postoperative evaluation. We analyzed the implant positions of seven rTHA patients with severe acetabular defects (Paprosky \u2265 Type IIIA) using an alignment technique that integrates postoperative 2D radiographs with preoperative CT plans. Two independent investigators, one inexperienced and one experienced, measured the positioning accuracy with both imaging modalities. Measurements included translational shifts from the preoperatively templated implant position in the craniocaudal (CC), lateromedial (LM), and ventrodorsal (VD) directions, as well as rotational differences in anteversion (AV) and inclination (INCL). The study demonstrated that 2D radiographs, when aligned with preoperative CT data, could accurately assess implant positions with precision nearly comparable to that of 3D CT scans. Observed deviations were 1.4 mm and 2.7 mm in CC and LM directions, respectively, and 3.6\u00b0 in AV and 0.7\u00b0 in INCL using 2D imaging, all within clinically acceptable ranges. For 3D CT assessments, mean interobserver variability was up to 0.9 mm for translational shifts and 1.4\u00b0 for rotation, while for 2D alignment, observer differences were 1.4 mm and 3.2\u00b0 for translation and rotation, respectively. Comparative analysis of mean results from both investigators, across all dimensions (CC, LM, AV, and INCL) for 2D and 3D matching, showed no significant differences. In conclusion, conventional anteroposterior 2D radiographs of the pelvis can sufficiently determine the positioning of custom-made acetabular implants in rTHA. This suggests that 2D radiography is a viable alternative to 3D CT scans, potentially enhancing the implementation and quality control of advanced implant technologies.<\/jats:p>","DOI":"10.3390\/jpm14080808","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T17:08:34Z","timestamp":1722359314000},"page":"808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Assessment Accuracy of 2D vs. 3D Imaging for Custom-Made Acetabular Implants in Revision Hip Arthroplasty"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4292-604X","authenticated-orcid":false,"given":"Timo Albert","family":"Nees","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Thomas","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz Maximilian","family":"Innmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Maximilian","family":"Spranz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9948-4209","authenticated-orcid":false,"given":"Fabian","family":"Westhauser","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Renkawitz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Reiner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: Total hip replacement","volume":"370","author":"Learmonth","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e22.00112","DOI":"10.2106\/JBJS.OA.22.00112","article-title":"Projections and Epidemiology of Primary Hip and Knee Arthroplasty in Medicare Patients to 2040\u20132060","volume":"8","author":"Shichman","year":"2023","journal-title":"JBJS Open Access"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1302\/0301-620X.93B3.25467","article-title":"Revision rates after total joint replacement","volume":"93-B","author":"Labek","year":"2011","journal-title":"J. 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