Bi-material attachment through a compliant interfacial system at the tendon-to-bone insertion site.

The attachment of tendon to bone, one of the greatest interfacial material mismatches in nature, presents an anomaly from the perspective of interfacial engineering. Deleterious stress concentrations arising at bi-material interfaces can be reduced in engineering practice by smooth interpolation of composition, microstructure, and mechanical properties. However, following normal development, the rotator cuff tendon-to-bone "insertion site" presents an interfacial zone that is more compliant than either tendon or bone. This compliant zone is not regenerated following healing, and its absence may account for the poor outcomes observed following both natural and post-surgical healing of insertion sites such as those at the rotator cuff of the shoulder. Here, we present results of numerical simulations which provide a rationale for such a seemingly illogical yet effective interfacial system. Through numerical optimization of a mathematical model of an insertion site, we show that stress concentrations can be reduced by a biomimetic grading of material properties. Our results suggest a new approach to functional grading for minimization of stress concentrations at interfaces.