The Role of the Loading Environment on the Developing Tendon-to-Bone Insertion

A transition zone forms at the attachment of tendon to bone during post-natal development [1]. We previously showed that this transitional tissue reduces stress concentrations at the insertion and hence reduces the risk for failure [2]. During tendon-to-bone healing, on the other hand, a transition zone does not develop at the interface [3]. Unlike development, inferior scar tissue fills the repair site and the repair is prone to rupture at the attachment. Understanding the development of the insertion will allow us to develop solutions to augment tendon-to-bone healing.