The role of mechanobiology in the attachment of tendon to bone

Abstract

The attachment of dissimilar materials is a major engineering challenge due to stress concentrations that arise at the interface of the disparate materials. An effective biologic solution to this problem can be seen at the attachment of the relatively compliant tendon to the relatively stiff and brittle bone. In this chapter, we review the functionally graded tissue that exists between tendon and bone. The focus of the chapter is the role of mechanobiology in the development, maintenance, and healing of the tendon-to-bone attachment; the role of mechanical stress on fetal and postnatal development and on tendon-to-bone during healing is discussed. A better understanding of mechanobiology at the insertion may help guide rehabilitation strategies and tissue engineering protocols for enhancing tendon-to-bone healing.