Development of a Statistical Shape Model and Assessment of Anatomical Shape Variations in the Hemipelvis

Willemina A. van Veldhuizen*, Hylke van der Wel, Hennie Y. Kuipers, Joep Kraeima, Kaj ten Duis, Jelmer M. Wolterink, Jean Paul P.M. de Vries, Richte C.L. Schuurmann, Frank F.A. IJpma

*Corresponding author for this work

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Knowledge about anatomical shape variations in the pelvis is mandatory for selection, fitting, positioning, and fixation in pelvic surgery. The current knowledge on pelvic shape variation mostly relies on point-to-point measurements on 2D X-ray images and computed tomography (CT) slices. Three-dimensional region-specific assessments of pelvic morphology are scarce. Our aim was to develop a statistical shape model of the hemipelvis to assess anatomical shape variations in the hemipelvis. CT scans of 200 patients (100 male and 100 female) were used to obtain segmentations. An iterative closest point algorithm was performed to register these 3D segmentations, so a principal component analysis (PCA) could be performed, and a statistical shape model (SSM) of the hemipelvis was developed. The first 15 principal components (PCs) described 90% of the total shape variation, and the reconstruction ability of this SSM resulted in a root mean square error of 1.58 (95% CI: 1.53–1.63) mm. In summary, an SSM of the hemipelvis was developed, which describes the shape variations in a Caucasian population and is able to reconstruct an aberrant hemipelvis. Principal component analyses demonstrated that, in a general population, anatomical shape variations were mostly related to differences in the size of the pelvis (e.g., PC1 describes 68% of the total shape variation, which is attributed to size). Differences between the male and female pelvis were most pronounced in the iliac wing and pubic rami regions. These regions are often subject to injuries. Future clinical applications of our newly developed SSM may be relevant for SSM-based semi-automatic virtual reconstruction of a fractured hemipelvis as part of preoperative planning. Lastly, for companies, using our SSM might be interesting in order to assess which sizes of pelvic implants should be produced to provide proper-fitting implants for most of the population.

Original languageEnglish
Article number3767
JournalJournal of Clinical Medicine
Issue number11
Publication statusPublished - Jun 2023


  • 3D geometrical model
  • osteosynthesis
  • pelvic fracture
  • pelvis
  • principal component analysis
  • statistical shape modeling


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