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Structural Interfaces and Attachments in Biology pp 69–89Cite as

Ligament and Tendon Enthesis: Anatomy and Mechanics

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Abstract

The insertions of ligaments and tendons to bone are morphologically and biomechanically complex. Within a short distance, the insertion (“enthesis”) is transformed from soft connective tissue to hard bone. In this chapter, we discuss the anatomy of the enthesis, including a review of the gross morphology as well as histology and appearance of two distinct types of insertions: the direct and indirect insertions to bone. The biomechanical function of insertion sites is then presented, including some challenges with methods involved in determining their properties. We then review the changes that occur across the insertion site during growth and skeletal maturity, using the femur-MCL-tibia complex as an example. The negative effects of immobilization on the insertion and its slow recovery following remobilization, together with positive effects of exercise, will then be presented.

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Acknowledgements

This work was supported in part by the Commonwealth of Pennsylvania, McGowan Institute for Regenerative Medicine, NIH (MCL Grant 14918), and an NSF ERC Grant (#0812348).

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Authors and Affiliations

  1. Musculoskeletal Research Center, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA

    Matteo M. Tei, Kathryn F. Farraro & Savio L.-Y. Woo

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  1. Matteo M. Tei
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  2. Kathryn F. Farraro
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  3. Savio L.-Y. Woo
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Correspondence to Savio L.-Y. Woo .

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Editors and Affiliations

  1. , Department of Orthopedic Surgery, Washington University, South Euclid 660, St. Louis, 63110, Missouri, USA

    Stavros Thomopoulos

  2. , Engineering Education Center, Missouri University of Science and Tech., University Blvd. One, St. Louis, 63121, Missouri, USA

    Victor Birman

  3. , Mechanical Engineering, Washington University, 1 Brookings Drive, St. Louis, 63130, Missouri, USA

    Guy M. Genin

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Tei, M.M., Farraro, K.F., Woo, S.LY. (2013). Ligament and Tendon Enthesis: Anatomy and Mechanics. In: Thomopoulos, S., Birman, V., Genin, G. (eds) Structural Interfaces and Attachments in Biology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3317-0_4

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  • DOI: https://doi.org/10.1007/978-1-4614-3317-0_4

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