ABSTRACT

Trauma and degeneration of the musculoskeletal system are commonly associated with injuries to so tissues such as cartilage which lines the surface of articulating joints, as well as ligaments and tendons, which connect bone to bone, and muscle to bone, respectively. Interfaces or insertion sites that connect these so tissues to bone are therefore ubiquitous in the body, and serve to facilitate synchronized joint motion and musculoskeletal function (Figure 32.1). ese interfaces exhibit a gradient of structural and mechanical properties that has a number of functions, from mediating load transfer between two distinct types of tissue to sustaining the heterotypic cellular communications required for interface function and homeostasis (Benjamin et al. 1986; Lu and Jiang 2006; Woo et al. 1988). ese critical junctions are however, prone to injury and unfortunately, not reestablished following standard surgical repair, and the failure to regenerate the intricate tissue-to-tissue interface has been reported to compromise gra stability and long term clinical outcome (Friedman et al. 1985; Robertson et al. 1986).