Morphological Evaluation of the Acetabulum in Adult Indian Dry Hip Bones: Implications for Total Hip Arthroplasty and the Role of Three-Dimensional Printing

Abstract

Background: The acetabulum, the bony socket of the hip joint, displays significant population-level morphological variation. Current acetabular implants for total hip arthroplasty (THA) are largely dimensioned on Caucasian and East Asian anthropometric data. Simultaneously, three-dimensional (3D) printing has emerged as a transformative technology for producing patient-specific implants, surgical guides, and anatomical models. Population-specific morphometric data combined with 3D printing offer a paradigm shift in THA planning and implant design for the Indian population. Objectives: To perform comprehensive morphometric analysis of the acetabulum in adult Indian dry hip bones and to evaluate the role and applications of 3D printing technology in THA planning, implant fabrication, and surgical training within the Indian clinical context. Materials & Methods: One hundred and twenty adult dry hip bones (78 male, 42 female; 62 right, 58 left) of confirmed Indian origin were studied from multi-institutional osteology collections. Eleven morphometric parameters were measured using digital verniercallipers, an acetabulometer, and goniometers. Literature on 3D printing applications in THA was systematically reviewed using PubMed, Scopus, and MEDLINE databases (2010–2024). Results: Mean acetabular transverse diameter was 45.8 ± 4.1 mm (males 47.3 ± 3.8 mm; females 43.6 ± 3.2 mm). Mean acetabular depth was 22.3 ± 2.6 mm. Elliptical morphology predominated (54.2%). Significant sexual dimorphism was observed across all linear measurements (p < 0.001). Comparison with published Caucasian data revealed consistently smaller diameters in Indian specimens. 3D printing applications reviewed included patient-specific acetabular cups, surgical cutting guides, pre-operative simulation models, and porous titanium ingrowth surfaces. Conclusion: The Indian acetabulum is morphometrically distinct from Western counterparts, with smaller diameters, greater ellipticity, and higher acetabular inclination in females. These population-specific data, when combined with 3D printing technology, enable manufacture of anatomically optimised acetabular implants, improving prosthetic fit, primary stability, and long-term osseointegration. Wider adoption of CT-derived 3D printing workflows in Indian orthopaedic practice is strongly recommended. Keywords: Acetabulum, morphometry, dry hip bone, Indian population, total hip arthroplasty, 3D printing, additive manufacturing, patient-specific implant, acetabular cup, sexual dimorphism.