Specialisation of extracellular matrix for function in tendons and ligaments

Abstract

Tendons and ligaments are similar structures in terms of their composition, organisation and mechanical properties. The distinction between them stems from their anatomical location; tendons form a link between muscle and bone while ligaments link bones to bones. A range of overlap-ping functions can be assigned to tendon and ligaments and each structure has specific mechanical properties which appear to be suited for par-ticular in vivo function. The extracellular matrix in tendon and ligament varies in accordance with function, providing appropriate mechanical prop-erties. The most useful framework in which to consider extracellular matrix differences therefore is that of function rather than anatomical location. In this review we discuss what is known about the relationship between functional requirements, structural properties from molecular to gross lev-el, cellular gene expression and matrix turnover. The relevance of this information is considered by reviewing clinical aspects of tendon and ligament repair and reconstructive procedures.