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The tendon-to-bone attachment

Unification through disarray

Nature Materials volume 16, pages 607–608 (2017)Cite this article

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High-resolution imaging, composition analysis and mechanical testing reveal a disordered transitional material within the Achilles tendon-to-bone attachment, structured as a fibrous network to enable force transfer and maximize structural integrity.

Joint motion is achieved through the transfer of muscle load from tendon to bone — two tissues with dramatically different compositions, structures and mechanical properties. From the continuum perspective, the Poisson ratios for stretching in this direction can differ by nearly one order of magnitude, while the moduli of tendon and bone along the direction of muscle force differ by nearly a hundredfold1. From the structural perspective, both are hierarchically organized, with nanoscale tropocollagen triple helices bundling into micrometre-diameter fibrils, which in turn bundle into fibres hundreds of micrometres in diameter and many millimetres long. In bone, the fibrils are stiffened by the cross-linking caused by the insertion and coating of bioapatite mineral crystals2,3. The tendon-to-bone attachment would be expected to fail from Bogy- or Williams-type free-edge singularities if stress concentrations at the interface were not attenuated with a suite of cross-scale deformation mechanisms4. Indeed, the rates of failure after surgical repair pose a major challenge5. How, then, does the healthy tendon-to-bone attachment achieve effective load transfer from one tissue to the other, and why does the healing attachment fail so frequently? The answer lies in a unique hierarchical transitional tissue that exists at the interface between these dissimilar materials, and identifying and restoring the resilience mechanisms of this material is now a major target for tendon-to-bone repair strategies6.

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Figure 1: The hierarchical structure of the tendon-to-bone attachment.
Figure 2: The random, fibrous nature of the tendon-to-bone attachment endows it with toughness while protecting tendon and bone.

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Authors and Affiliations

  1. and the Department of Mechanical Engineering and Materials Science, and the Department of Neurological Surgery at Washington University in St Louis, Guy Genin is at the Bioinspired Engineering and Biomechanics Center (BEBC), the Key Laboratory of Biomedical Information Engineering, Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China, School of Engineering and Applied Science, Missouri 63130, USA,

    Guy M. Genin

  2. Stavros Thomopoulos is in the Department of Orthopedic Surgery, and the Department of Biomedical Engineering at Columbia University, New York 10032, USA,

    Stavros Thomopoulos

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  1. Guy M. Genin
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  2. Stavros Thomopoulos
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Correspondence to Guy M. Genin or Stavros Thomopoulos.

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Genin, G., Thomopoulos, S. Unification through disarray. Nature Mater 16, 607–608 (2017). https://doi.org/10.1038/nmat4906

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