{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:38:30Z","timestamp":1788262710801,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Agencia Estatal de Investigaci\u00f3n (AEI)\u2013Proyectos de Transici\u00f3n Ecol\u00f3gica y Digital 2021","award":["TED2021-132200B-I00"],"award-info":[{"award-number":["TED2021-132200B-I00"]}]},{"name":"Agencia Estatal de Investigaci\u00f3n (AEI)\u2013Proyectos de Transici\u00f3n Ecol\u00f3gica y Digital 2021","award":["PT23\/00116"],"award-info":[{"award-number":["PT23\/00116"]}]},{"name":"Biomodels and Biobanks Platform","award":["TED2021-132200B-I00"],"award-info":[{"award-number":["TED2021-132200B-I00"]}]},{"name":"Biomodels and Biobanks Platform","award":["PT23\/00116"],"award-info":[{"award-number":["PT23\/00116"]}]},{"name":"PTI FAB3D","award":["TED2021-132200B-I00"],"award-info":[{"award-number":["TED2021-132200B-I00"]}]},{"name":"PTI FAB3D","award":["PT23\/00116"],"award-info":[{"award-number":["PT23\/00116"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Objectives: Pelvic tumor resections demand high surgical precision to ensure clear margins while preserving function. Although patient-specific instruments (PSIs) improve osteotomy accuracy, positioning errors remain a limitation. This study evaluates the feasibility, accuracy, and usability of a novel dual-function augmented reality (AR) system for intraoperative guidance in PSI positioning and osteotomy execution using a head-mounted display (HMD). The system provides dual-function support by assisting both PSI placement and osteotomy execution. Methods: Ten fresh-frozen cadaveric hemipelves underwent AR-assisted internal hemipelvectomy, using customized 3D-printed PSIs and a new in-house AR software integrated into an HMD. Angular and translational deviations between planned and executed osteotomies were measured using postoperative CT analysis. Absolute angular errors were computed from plane normals; translational deviation was assessed as maximum error at the osteotomy corner point in both sagittal (pitch) and coronal (roll) planes. A Wilcoxon signed-rank test and Bland\u2013Altman plots were used to assess intra-workflow cumulative error. Results: The mean absolute angular deviation was 5.11 \u00b1 1.43\u00b0, with 86.66% of osteotomies within acceptable thresholds. Maximum pitch and roll deviations were 4.53 \u00b1 1.32 mm and 2.79 \u00b1 0.72 mm, respectively, with 93.33% and 100% of osteotomies meeting translational accuracy criteria. Wilcoxon analysis showed significantly lower angular error when comparing final executed planes to intermediate AR-displayed planes (p &lt; 0.05), supporting improved PSI positioning accuracy with AR guidance. Surgeons rated the system highly (mean satisfaction \u2265 4.0) for usability and clinical utility. Conclusions: This cadaveric study confirms the feasibility and precision of an HMD-based AR system for PSI-guided pelvic osteotomies. The system demonstrated strong accuracy and high surgeon acceptance, highlighting its potential for clinical adoption in complex oncologic procedures.<\/jats:p>","DOI":"10.3390\/bioengineering12080810","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:05:47Z","timestamp":1753711547000},"page":"810","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility and Accuracy of a Dual-Function AR-Guided System for PSI Positioning and Osteotomy Execution in Pelvic Tumour Surgery: A Cadaveric Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6861-0644","authenticated-orcid":false,"given":"Tanya","family":"Fern\u00e1ndez-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Musculoskeletal Oncology Division, Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Orozco-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Lower Limb Division, Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6151-6786","authenticated-orcid":false,"given":"Carla","family":"de Gregorio-Bermejo","sequence":"additional","affiliation":[{"name":"Advanced Planning and 3D Manufacturing Unit (UPAM3D), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Aguilera-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Advanced Planning and 3D Manufacturing Unit (UPAM3D), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Iribar-Zabala","sequence":"additional","affiliation":[{"name":"Digital Health and Biomedical Technologies, Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), 20009 Donostia-San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-1117","authenticated-orcid":false,"given":"Lydia","family":"Mediavilla-Santos","sequence":"additional","affiliation":[{"name":"Musculoskeletal Oncology Division, Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1484-731X","authenticated-orcid":false,"given":"Javier","family":"Pascau","sequence":"additional","affiliation":[{"name":"Bioengineering Department, Universidad Carlos III de Madrid, 28911 Legan\u00e9s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7330-9194","authenticated-orcid":false,"given":"M\u00f3nica","family":"Garc\u00eda-Sevilla","sequence":"additional","affiliation":[{"name":"Bioengineering Department, Universidad Carlos III de Madrid, 28911 Legan\u00e9s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-2759","authenticated-orcid":false,"given":"Rub\u00e9n","family":"P\u00e9rez-Ma\u00f1anes","sequence":"additional","affiliation":[{"name":"Advanced Planning and 3D Manufacturing Unit (UPAM3D), Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Antonio","family":"Calvo-Haro","sequence":"additional","affiliation":[{"name":"Musculoskeletal Oncology Division, Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Dr. Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1177\/14574969231181504","article-title":"Pelvic Bone Sarcomas, Prognostic Factors, and Treatment: A Narrative Review of the Literature","volume":"112","author":"Laitinen","year":"2023","journal-title":"Scand. 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Surg."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/810\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:17:18Z","timestamp":1760033838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["bioengineering12080810"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12080810","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}