Apostolakos John, Durant Thomas Js, Dwyer Corey R, Russell Ryan P, Weinreb Jeffrey H, Alaee Farhang, Beitzel Knut, McCarthy Mary Beth, Cote Mark P, Mazzocca Augustus D
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT, USA.
Department of Orthopaedic Sportsmedicine, Technical University Munich, Germany.
Muscles Ligaments Tendons J. 2014 Nov 17;4(3):333-42. eCollection 2014 Jul.
The integration of tendon into bone occurs at a specialized interface known as the enthesis. The fibrous tendon to bone enthesis is established through a structurally continuous gradient from uncalcified tendon to calcified bone. The enthesis exhibits gradients in tissue organization classified into four distinct zones with varying cellular compositions, mechanical properties, and functions in order to facilitate joint movement. Damage to tendinous insertions is common in the field of orthopaedic medicine and often involves surgical intervention that requires the attempted recreation of the natural organization of tendon into bone. The difficulty associated with recreating the distinct organization may account for the surgical challenges associated with reconstruction of damaged insertion sites. These procedures are often associated with high failure rates and consequently require revision procedures. Management of tendinous injuries and reconstruction of the insertion site is becoming a popular topic in the field of orthopaedic medicine.
肌腱与骨的整合发生在一个称为附着点的特殊界面。纤维性肌腱-骨附着点是通过从未钙化的肌腱到钙化骨的结构连续梯度建立的。附着点在组织结构上呈现出梯度变化,分为四个不同的区域,具有不同的细胞组成、力学性能和功能,以促进关节运动。肌腱附着处的损伤在骨科医学领域很常见,通常需要手术干预,试图重现肌腱与骨的自然组织结构。重建独特组织的困难可能是与受损附着点重建相关的手术挑战的原因。这些手术往往失败率很高,因此需要翻修手术。肌腱损伤的处理和附着点的重建正成为骨科医学领域一个热门话题。