The development and morphogenesis of the tendon-to-bone insertion - what development can teach us about healing -.
The development and morphogenesis of the tendon-to-bone insertion - what development can teach us about healing -.
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发表时间：
2010-03
影响因子：
1.9
通讯作者：
S. Thomopoulos;G. Genin;L. Galatz
中科院分区：
文献类型：
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作者：
S. Thomopoulos;G. Genin;L. Galatz
不同材料的连接是一个主要的挑战，因为在这样的界面处产生高水平的应力。这个问题的有效解决方案是将肌腱（一种柔顺的“软组织”）附着在骨骼（一种坚硬的“硬组织”）上。这种组织，即“附着点”，通过结构、组成和机械性能的渐变从肌腱过渡到骨。这些等级在肌腱-骨愈合过程中不会再生，导致手术修复后失败的发生率很高。了解附着点的发育可能使科学家能够开发再生天然肌腱-骨附着的治疗方法。最近的研究表明，生物和机械因素驱动着附着点的发育和形态发生。类似于生长板中所见的生物信号级联促进附着点骨端软骨的矿化和附着点肌腱端纤维软骨的形成。机械载荷对于附着点的发育也是必要的。去除肌肉负荷会损害发育中的附着点处的骨、纤维软骨和肌腱的形成。本文综述了近几年来附着点的研究进展，重点介绍了生物学和力学因素在附着点研究中的作用。
The attachment of dissimilar materials is a major challenge because of the high levels of stress that develop at such interfaces. An effective solution to this problem develops at the attachment of tendon (a compliant "soft tissue") to bone (a stiff "hard tissue"). This tissue, the "enthesis", transitions from tendon to bone through gradations in structure, composition, and mechanical properties. These gradations are not regenerated during tendon-to-bone healing, leading to a high incidence of failure after surgical repair. Understanding the development of the enthesis may allow scientists to develop treatments that regenerate the natural tendon-to-bone insertion. Recent work has demonstrated that both biologic and mechanical factors drive the development and morphogenesis of the enthesis. A cascade of biologic signals similar to those seen in the growth plate promotes mineralization of cartilage on the bony end of the enthesis and the formation of fibrocartilage on the tendon end of the enthesis. Mechanical loading is also necessary for the development of the enthesis. Removal of muscle load impairs the formation of bone, fibrocartilage, and tendon at the developing enthesis. This paper reviews recent work on the development of the enthesis, with an emphasis on the roles of biologic and mechanical factors.