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RESEARCH ARTICLE

Accuracy validation of patient-specific 3D-printed acetabular revision prostheses: A stereotactic accuracy analysis

Dinghao Luo1 ,  Zhaoyang Ran1 ,  Junxiang Wu1 ,  Liang Deng1* ,  Yongqiang Hao1,2,3,4*
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1 Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2 Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
3 3D Printing Technology Clinical and Translational Research Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
4 Shanghai Engineering Research Center of Innovative Orthopaedic Instruments and Personalized Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
IJB, 025120096 https://doi.org/10.36922/IJB025120096
Received: 19 March 2025 | Accepted: 27 March 2025 | Published online: 27 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Assessing the positioning of prostheses after surgery is essential for evaluating therapeutic efficacy and optimizing surgical methods in three-dimensional (3D)- printed patient-specific acetabular revision implants. However, the lack of an effective 3D accuracy assessment framework for these customized implants has impeded the development of standardized benchmarks for verifying spatial alignment between intraoperative placement and preoperative digital planning. To bridge this gap, we introduce a novel evaluation system that integrates point localization, vector-based angular assessment, and volumetric overlap analysis to comprehensively quantify alignment between implanted prostheses and preoperative templates. Patients were classified into cohorts according to postoperative Harris Hip Scores (HHS) and complication profiles, differentiating a “better outcome” group (HHS ≥ 80, no major complications) from a “regular outcome” group. A computed tomography (CT)-based pelvic 3D coordinate system, established through anatomical landmarks, facilitated comparative analyses of intergroup variations in positional deviation, angular deviation, and volumetric overlap accuracy. The system’s reliability was confirmed via inter- and intra-observer consistency tests. Findings revealed outstanding measurement consistency (κ > 0.8). Compared to the regular outcome group, patients with better outcomes demonstrated significantly lower positional deviations (p < 0.001) and angular deviations (p = 0.003), along with superior volumetric overlap accuracy (p < 0.001). This CT-guided stereotactic assessment system offers a clinically relevant, high-fidelity approach for evaluating postoperative implant placement in 3D-printed acetabular prostheses. Notably, it represents the first validated methodology leveraging a pelvic 3D coordinate framework for a comprehensive analysis of preoperative planning versus postoperative implant positioning.

Graphical abstract
Keywords
3D spatial analysis
Acetabular revision prostheses
Patient-specific implants
Surgical accuracy
Funding
This study was supported by the National Key R&D Program of China (2022YFC2406000), the National Natural Science Foundation of China (52401056), the Shanghai Pujiang Program (Grant no. 23PJ1421600), Fund for Promoting High-Quality Industrial Development from the Shanghai Municipal Commission of Economy and Informatization (2024-GZL-RGZN-01023), the Biomaterials and Regenerative Medicine Institute Cooperative Research Project, Shanghai Jiao Tong University School of Medicine (No. 2022LHA01), and the “Clinical+” Program of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (JYLJ202201).
Conflict of interest
The authors declare that they have no commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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