Tailoring the Gross Morphology of the Tendon-to-Bone Insertion for the Reduction of Stress Concentrations

Attaching dissimilar materials is a major challenge in engineering, and has proven to be a challenge in surgical practice as well [1]. At the tensile connection of tendon to bone, a two order-of-magnitude mismatch exists, leading to stress concentrations and the potential for failure [2–3]. Here, we examine one material attachment strategy employed at this connection to achieve effective load transfer between a healing tendon and bone: shaping of gross tissue morphology [4]. Our ultimate goal is to understand the mechanisms of stress transfer at the tendon-to-bone insertion. This understanding may lead to biomimetic attachment strategies that will benefit engineering practice and improve surgical healing outcomes.