After tendon or ligament reconstruction, the interface between the hard bone and soft connective tissue is considerably weakened and is difficult to restore through healing. The tendon/ligament–bone interface is mechanically the weakest point under tensile loading and is often the source of various postoperative complications, such as bone resorption and graft laxity. A comprehensive understanding of the macro- and microfeatures of the native tendon/ligament–bone interface would be beneficial for developing strategies for regenerating the tissue. This article discusses the structural, biological, and mechanical features of the tendon/ligament–bone interfaces and how these can be affected by aging and loading conditions.
Impact statement
This review provides an up-to-date summary of the structural, biological, and mechanical features of the tendon/ligament–bone interfaces, and how these can be affected by aging and loading conditions. A thorough understanding of these features provides critical foundation for developing advanced techniques for ligament/tendon reconstruction and soft–hard tissue interface engineering.
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