Benjamin M, Kumai T, Milz S, Boszczyk B M, Boszczyk A A, Ralphs J R
School of Biosciences, P.O. Box 911, Museum Avenue, Cardiff University, Cardiff CF10 3US, Wales, UK.
Comp Biochem Physiol A Mol Integr Physiol. 2002 Dec;133(4):931-45. doi: 10.1016/s1095-6433(02)00138-1.
Tendon entheses can be classed as fibrous or fibrocartilaginous according to the tissue present at the skeletal attachment site. The former can be "bony" or "periosteal", depending on whether the tendon is directly attached to bone or indirectly to it via the periosteum. At fibrocartilaginous entheses, the uncalcified fibrocartilage dissipates collagen fibre bending and tendon narrowing away from the tidemark; calcified fibrocartilage anchors the tendon to the bone and creates a diffusion barrier between the two. Where there are additional fibrocartilaginous specialisations in the tendon and/or bone next to the enthesis, an "enthesis organ" is created that reduces wear and tear. Little attention has been paid to bone at entheses, despite the obvious bearing this has on the mechanical properties of the interface and the clinical importance of avulsion fractures. Disorders at entheses (enthesopathies) are common and occur in conditions such as diffuse idiopathic skeletal hyperostosis and the seronegative spondyloarthropathies. They are also commonly seen as sporting injuries such as tennis elbow and jumper's knee.
根据骨骼附着部位存在的组织，肌腱附着点可分为纤维性或纤维软骨性。前者可分为“骨性”或“骨膜性”，这取决于肌腱是直接附着于骨还是通过骨膜间接附着于骨。在纤维软骨性附着点，未钙化的纤维软骨可消散胶原纤维的弯曲，并使肌腱远离潮线处变窄；钙化的纤维软骨将肌腱固定于骨，并在两者之间形成扩散屏障。在附着点旁的肌腱和/或骨中存在额外的纤维软骨特化结构时，会形成一个“附着点器官”，可减少磨损。尽管附着点处的骨对界面的力学性能及撕脱骨折的临床重要性有明显影响，但人们对其关注甚少。附着点疾病（附着点病）很常见，见于弥漫性特发性骨肥厚和血清阴性脊柱关节病等情况。它们也常表现为运动损伤，如网球肘和跳跃膝。
