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Dive into the research topics where Claudio Belvedere is active.

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Featured researches published by Claudio Belvedere.


Clinical Biomechanics | 2011

Multi-segment trunk kinematics during locomotion and elementary exercises.

Alberto Leardini; F. Biagi; A. Merlo; Claudio Belvedere; Maria Grazia Benedetti

BACKGROUND Motion of human trunk segments in healthy subjects during activities of daily living has been described either with oversimplified models or with cumbersome techniques of isolated anatomical complex. This study describes multi-segmental trunk motion based on a new technique which is a compromise between technical limitations, implied with the experiments, and clinical relevance. METHODS The thorax segment was tracked by the optimal spatial matching of four thoracic markers. The separate bi-dimensional shoulder line rotations and translations with respect to the thorax were calculated by markers on the two acromions. Spine motion was characterised by a 5-link-segment model from additional four skin markers, in the anatomical reference frame based on four pelvic spine markers. These 14 markers were tracked in 10 healthy subjects and one clinical case during static upright posture, chair rising-sitting, step up-and-down and level walking, and also during elementary flexion and extension, lateral bending, and axial rotation movements of the entire trunk. FINDINGS Intra-subject repeatability over ten repetitions was found to be high for most of the measurements, with average standard deviations of less than 1.8° for all planar rotations at the spine, and less smaller than 1mm for shoulder translations. Large motion, albeit with different patterns, was found in all subjects, also revealing interesting couplings over the three anatomical planes. INTERPRETATION Considerable subject-specific motion occurs at each of these different trunk segments in all three anatomical planes, in simple exercises and in motor tasks of daily living. Measurements taken with the present new trunk model in pathological subjects shall reveal corresponding patterns and ranges of motion in abnormal conditions.


Journal of Orthopaedic Research | 2009

In vivo kinematics and kinetics of a bi-cruciate substituting total knee arthroplasty: A combined fluoroscopic and gait analysis study

Fabio Catani; Andrea Ensini; Claudio Belvedere; Alessandro Feliciangeli; Maria Grazia Benedetti; Alberto Leardini; Sandro Giannini

After total knee arthroplasty, changes in articular surface geometry, soft tissue treatment, and component alignment can alter normal lower limb function. The guided motion bi‐cruciate substituting prosthesis was designed specifically to restore physiological knee joint motion. We determined whether this design could in vivo normal kinematics and kinetics, not only at the replaced knee, but also throughout both lower limbs. Sixteen patients (4 male, 12 female, mean age of 68.2 years with a range from 58 to 79 years) with primary knee osteoarthritis were implanted with the bi‐cruciate substituting prosthesis. At 6‐month follow‐up, knee joint kinematics was assessed by video‐fluoroscopy during stair‐climbing, chair‐rising/sitting, and step‐up/down. Lower limb overall function was also assessed on the same day by standard gait analysis with simultaneous electromyography during level walking. By video‐fluoroscopy, mean anteroposterior translations between femoral and tibial components during the three motor tasks were 9.7 ± 3.0, 10 ± 2.6, and 6.9 ± 3.5 mm on the medial compartment, and 14.3 ± 3.5, 18.5 ± 3.0, and 13.9 ± 3.8 mm on the lateral compartment, respectively. Axial rotation ranged from 5.6° to 26.2°. Gait analysis revealed restoration of nearly normal walking patterns in most patients. This rare combination of measurements, i.e., accurate rotation‐translation at the replaced knee and complete locomotion patterns at both lower limb joints, suggested that bi‐cruciate substituting arthroplasty can restore physiological knee motion and normal overall function.


Clinical Biomechanics | 2009

Quantitative comparison of current models for trunk motion in human movement analysis

Alberto Leardini; F. Biagi; Claudio Belvedere; Maria Grazia Benedetti

BACKGROUND A number of different models for human trunk kinematics during locomotion have been proposed, though mainly addressing specific clinical questions rather than general populations. These differ considerably for the skeletal segments considered, marker-set, anatomical axis and frame definitions, and joint conventions. The scope of the present study is to compare quantitatively these models on the basis of the same motion. METHODS Ten subjects were analysed, instrumented with a single comprehensive marker-set of 14 markers identified from the union of the corresponding from eight current models for trunk kinematics. Activities of daily living (walking, chair rising/sitting, step-up/down), elementary trunk movements (flexion, bending and axial rotation), and isolated motion of the shoulders, both synchronous and asynchronous were collected. Resulting rotations in the three anatomical planes, both in the laboratory and in the pelvis reference frames, were calculated. FINDINGS In addition to the expected bias between the rotation angle time-histories, very different patterns and range of motion were found between the models. In chair rising/sitting, and in the laboratory global frame, the range of flexion averaged over the subjects was measured by the different models in the full scale from about 28 degrees to 44 degrees. In elementary trunk rotation and in the pelvis anatomical reference frame, three models measured about 10 degrees excursion of the coupled bending motion, other two about 38 degrees and 49 degrees on average. INTERPRETATION In trunk kinematics analysis, it is recommended that all models, both in terms of markers involved and of reference frame definitions, are understood carefully before interpreting the results in clinical decision making.


Clinical Orthopaedics and Related Research | 2010

The Mark Coventry Award: Articular contact estimation in TKA using in vivo kinematics and finite element analysis.

Fabio Catani; Bernardo Innocenti; Claudio Belvedere; Luc Labey; Andrea Ensini; Alberto Leardini

In vivo fluoroscopy is a well-known technique to analyze joint kinematics of the replaced knee. With this method, however, the contact areas between femoral and tibial components, fundamental for monitoring wear and validating design concepts, are hard to identify. We developed and tested a novel technique to assess condylar and post-cam contacts in TKA. The technique uses in vivo motion data of the replaced knee from standard fluoroscopy as input for finite element models of the prosthesis components. In these models, tibiofemoral contact patterns at the condyles and post-cam articulations were calculated during various activities. To test for feasibility, the technique was applied to a bicruciate posterior-stabilized prosthesis. Sensitivity of the finite element analysis, validation of the technique, and in vivo tests were performed. To test for potential in the clinical setting, five patients were preliminarily analyzed during chair rising-sitting, stair climbing, and step up-down. For each task and patient, the condylar contact points and contact line rotation were calculated. The results were repeatable and consistent with corresponding calculations from traditional fluoroscopic analysis. Specifically, natural knee kinematics, which shows rolling back and screw home, seemed replicated in all motor tasks. Post-cam contact was observed on both the anterior and posterior faces. Anterior contact is limited to flexion angle close to extension; posterior contact occurs in deeper flexion but is dependent on the motor task. The data suggest the proposed technique provides reliable information to analyze post-cam contacts.


Journal of Biomechanics | 2009

A new one-DOF fully parallel mechanism for modelling passive motion at the human tibiotalar joint

Riccardo Franci; Vincenzo Parenti-Castelli; Claudio Belvedere; A. Leardini

Knowledge on how ligaments and articular surfaces guide passive motion at the human ankle joint complex is fundamental for the design of relevant surgical treatments. The paper presents a possible improvement of this knowledge by a new kinematic model of the tibiotalar articulation. Passive motion, i.e. in virtually unloaded conditions, was captured in vitro in four lower leg specimens by means of a surgical navigation system with cluster of active markers attached to the tibia and talus. The anatomical geometry of the passive structures, i.e. articular surfaces and attachment areas of the ligaments, were taken by digitisation with a pointer. An equivalent spatial mechanism for the passive motion simulation was defined by three sphere-to-sphere contact points and two rigid links. These contact points were identified at the lateral talo-fibular articulation and at the medial and lateral aspects of the articulation between tibial mortise and trochlea tali. The two rigid links were identified by the isometric fibres at the calcaneofibular and tibiocalcaneal ligaments. An optimisation algorithm was developed for the identification of the final geometrical parameters resulting from an iterative refining process, which targets best matching between model predictions and corresponding experimental measurements of the spatial motion. The specimen-specific equivalent spatial mechanisms replicated the original passive motion very well, with mean discrepancies in position smaller than 2.5 mm and in rotation smaller than 1 degrees . The study demonstrates that the articular surfaces and the ligaments, acting together as a mechanism, control the passive kinematics of the ankle joint.


Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine | 2010

Articular surface approximation in equivalent spatial parallel mechanism models of the human knee joint: An experiment-based assessment

A. Ottoboni; Vincenzo Parenti-Castelli; Nicola Sancisi; Claudio Belvedere; A. Leardini

Abstract In-depth comprehension of human joint function requires complex mathematical models, which are particularly necessary in applications of prosthesis design and surgical planning. Kinematic models of the knee joint, based on one-degree-of-freedom equivalent mechanisms, have been proposed to replicate the passive relative motion between the femur and tibia, i.e. the joint motion in virtually unloaded conditions. In the mechanisms analysed in the present work, some fibres within the anterior and posterior cruciate and medial collateral ligaments were taken as isometric during passive motion, and articulating surfaces as rigid. The shapes of these surfaces were described with increasing anatomical accuracy, i.e. from planar to spherical and general geometry, which consequently led to models with increasing complexity. Quantitative comparison of the results obtained from three models, featuring an increasingly accurate approximation of the articulating surfaces, was performed by using experimental measurements of joint motion and anatomical structure geometries of four lower-limb specimens. Corresponding computer simulations of joint motion were obtained from the different models. The results revealed a good replication of the original experimental motion by all models, although the simulations also showed that a limit exists beyond which description of the knee passive motion does not benefit considerably from further approximation of the articular surfaces.


Journal of Orthopaedic Research | 2011

In‐Vivo knee kinematics in rotationally unconstrained total knee arthroplasty

Fabio Catani; Claudio Belvedere; Andrea Ensini; Alessandro Feliciangeli; Sandro Giannini; Alberto Leardini

Total knee replacement designs claim characteristic kinematic performance that is rarely assessed in patients. In the present study, in vivo kinematics of a new prosthesis design was measured during activities of daily living. This design is posterior stabilized for which spine–cam interaction coordinates free axial rotation throughout the flexion–extension arc by means of a single radius of curvature for the femoral condyles in the sagittal and frontal planes. Fifteen knees were implanted with this prosthesis, and 3D video‐fluoroscopic analysis was performed at 6‐month follow‐up for three motor tasks. The average range of flexion was 70.1° (range: 60.1–80.2°) during stair‐climbing, 74.7° (64.6–84.8°) during chair‐rising, and 64.1° (52.9–74.3°) during step‐up. The corresponding average rotation on the tibial base‐plate of the lines between the medial and lateral contact points was 9.4° (4.0–22.4°), 11.4° (4.6–22.7°), and 11.3° (5.1–18.0°), respectively. The pivot point for these lines was found mostly in the central area of the base‐plate. Nearly physiological range of axial rotation can be achieved at the replaced knee during activities of daily living.


Journal of Biomechanics | 2012

Geometrical changes of knee ligaments and patellar tendon during passive flexion.

Claudio Belvedere; Andrea Ensini; Alessandro Feliciangeli; Francesco Cenni; Valentina D'Angeli; Sandro Giannini; Alberto Leardini

Patterns of fibre elongation and orientation for the cruciate and collateral ligaments of the human knee joint and for the patellar tendon have not yet been established in three-dimensions. These patterns are essential for understanding thoroughly the contribution of these soft tissues to joint function and of value in surgical treatments for a more conscious assessment of the knee status. Measurements from 10 normal cadaver knees are here reported using an accurate surgical navigation system and consistent anatomical references, over a large flexion arc, and according to current recommended conventions. The contours of relevant sub-bundles were digitised over the corresponding origins and insertions on the bones. Representative fibres were calculated as the straight line segments joining the centroids of these attachment areas. The most isometric fibre was also taken as that whose attachment points were at the minimum change in length over the flexion arc. Changes in length and orientation of these fibres were reported versus the flexion angle. A good general repeatability of intra- and inter-specimens was found. Isometric fibres were found in the locations reported in the literature. During knee flexion, ligament sub-bundles slacken in the anterior cruciate ligament, and in the medial and lateral collateral ligaments, whereas they tighten in the posterior cruciate ligament. In each cruciate ligament the two compounding sub-bundles have different extents for the change in fibre length, and also bend differently from each other on both tibial planes. In the collateral ligaments and patellar tendon all fibres bend posteriorly. Patellar tendon underwent complex changes in length and orientation, on both the tibial sagittal and frontal planes. For the first time thorough and consistent patterns of geometrical changes are provided for the main knee ligaments and tendons after careful fibre mapping.


Journal of Orthopaedic Research | 2009

Three-dimensional patellar motion at the natural knee during passive flexion/extension. An in vitro study

Claudio Belvedere; Alberto Leardini; Andrea Ensini; Luca Bianchi; Fabio Catani; Sandro Giannini

Patellar maltracking may result in many patellofemoral joint (PFJ) disorders in the natural and replaced knee. The literature providing quantitative reference for normal PFJ kinematics according to which patellar maltracking could be identified is still limited. The aim of this study was to measure in vitro accurately all six‐degrees‐of‐freedom of patellar motion with respect to the femur and tibia on 20 normal specimens. A state‐of‐the‐art knee navigation system, suitably adapted for this study aim, was used. Anatomical reference frames were defined for the femur, tibia, and patella according to international recommendations. PFJ flexion, tilt, rotation, and translations were calculated in addition to standard tibiofemoral joint (TFJ) kinematics. All motion patterns were found to be generally repeatable intra‐/interspecimens. PFJ flexion was 62% of the corresponding TFJ flexion range; tilt and translations along femoral mediolateral and tibial proximodistal axes during TFJ flexion were found with medial, lateral, and distal trends and within 12°, 6 and 9 mm, respectively. No clear pattern for PFJ rotation was observed. These results concur with comparable reports from the literature and contribute to the controversial knowledge on normal PFJ kinematics. Their consistence provides fundamental information to understand orthopedic treatment of the knee and for possible relevant measurements intraoperatively.


Medical Engineering & Physics | 2014

A new protocol from real joint motion data for wear simulation in total knee arthroplasty: Stair climbing

Santina Battaglia; Claudio Belvedere; Sami Abdel Jaber; Saverio Affatato; Valentina D’Angeli; Alberto Leardini

In its normal lifespan, a knee prosthesis must bear highly demanding loading conditions, going beyond the sole activity of level walking required by ISO standard 14243. We have developed a protocol for in vitro wear simulation of stair climbing on a displacement controlled knee simulator. The flexion/extension angle, intra/extra rotation angle, and antero/posterior translation were obtained in patients by three-dimensional video-fluoroscopy. Axial load data were collected by gait analysis. Kinematics and load data revealed a good consistence across patients, in spite of the different prosthesis size. The protocol was then implemented and tested on a displacement controlled knee wear simulator, showing an accurate reproduction of stair climbing waveforms with a relative error lower than 5%.

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Fabio Catani

University of Modena and Reggio Emilia

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Francesco Cenni

Katholieke Universiteit Leuven

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