Orthopedic Interface Repair Strategies Based on Native Structural and Mechanical Features of the Multiscale Enthesis.
Orthopedic Interface Repair Strategies Based on Native Structural and Mechanical Features of the Multiscale Enthesis.
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DOI：
10.1021/acsbiomaterials.6b00599
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发表时间：
2017-11
影响因子：
5.8
通讯作者：
R. C. Locke;Adam C. Abraham;M. Killian
中科院分区：
文献类型：
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作者：
R. C. Locke;Adam C. Abraham;M. Killian
髋端是一个器官，通过纤维软骨界面将柔软、排列的组织（肌腱/韧带）与坚硬、无定形的组织（骨）连接起来。机械上，内装体维持一个动态加载环境，包括拉伸、压缩和剪切力。接合体的结构成分起到最小化应力集中和控制界面拉伸的作用。目前的手术修复，如肩袖修复和前十字韧带重建，目的是通过软硬组织的再附着或移植物置换来弥合损伤端之间的间隙。在这篇综述中，我们讨论了纤维软骨附着的多尺度、形态学和力学特征。此外，我们回顾历史和最近的临床方法治疗肠末损伤。最后，我们探讨了组织工程生物材料在临床前研究中显示出前景的新技术进展。
The enthesis is an organ that connects a soft, aligned tissue (tendon/ligament) to a hard, amorphous tissue (bone) via a fibrocartilage interface. Mechanically, the enthesis sustains a dynamic loading environment that includes tensile, compressive, and shear forces. The structural components of the enthesis act to minimize stress concentrations and control stretch at the interface. Current surgical repair of the enthesis, such as in rotator cuff repair and anterior cruciate ligament reconstruction, aim to bridge the gap between the injured ends via reattachment of soft-to-hard tissues or graft replacement. In this review, we discuss the multiscale, morphological, and mechanical characteristics of the fibrocartilage attachment. Additionally, we review historical and recent clinical approaches to treating enthesis injury. Lastly, we explore new technological advancements in tissue-engineered biomaterials that have shown promise in preclinical studies.