Abstract：
Connective tissue attaches to bone across an insertion with spatial gradients in components, microstructure, and biomechanics. Due to regional stress concentrations between two mechanically dissimilar materials, the insertion is vulnerable to mechanical damage during joint movements and difficult to repair completely, which remains a significant clinical challenge. Despite interface stress concentrations, the native insertion physiologically functions as the effective load-transfer device between soft tissue and bone. This review summarizes tendon, ligament, and meniscus insertions cross-sectionally, which is novel in this field. Herein, the similarities and differences between the three kinds of insertions in terms of components, microstructure, and biomechanics are compared in great detail. This review begins with describing the basic components existing in the four zones (original soft tissue, uncalcified fibrocartilage, calcified fibrocartilage, and bone) of each kind of insertion, respectively. It then discusses the microstructure constructed from collagen, glycosaminoglycans (GAGs), minerals and others, which provides key support for the biomechanical properties and affects its physiological functions. Finally, the review continues by describing variations in mechanical properties at the millimeter, micrometer, and nanometer scale, which minimize stress concentrations and control stretch at the insertion. In summary, investigating the contrasts between the three has enlightening significance for future directions of repair strategies of insertion diseases and for bioinspired approaches to effective soft-hard interfaces and other tough and robust materials in medicine and engineering.
摘要：
结缔组织通过插入部分附着在骨骼上，成分具有空间梯度，微观结构，和生物力学。由于两种机械上不同的材料之间的区域应力集中，在关节运动过程中，插入容易受到机械损伤，并且难以完全修复，这仍然是一个重大的临床挑战。尽管界面应力集中，自然插入的生理功能作为软组织和骨骼之间的有效负荷传递装置。这篇综述总结了肌腱，韧带,和半月板插入的横截面，这在这个领域很新颖。在这里，三种插入在组件方面的异同，微观结构，和生物力学进行了详细的比较。这篇综述首先描述了四个区域(原始软组织，未钙化的纤维软骨，钙化纤维软骨，和骨骼)的每种插入，分别。然后讨论了由胶原蛋白构成的微观结构，糖胺聚糖（GAG），矿物和其他为其生物力学特性提供了关键支撑,并影响其生理功能。最后,审查继续描述毫米的机械性能变化，千分尺,和纳米尺度，最大限度地减少应力集中和控制拉伸插入。总之,研究两者之间的对比对于插入疾病的修复策略的未来方向以及有效的软-硬界面和其他坚韧和坚固的材料在医学和工程中的生物启发方法具有启发意义。
