Microstructural and micromechanical investigation of the tendon-bone attachment

We observed an evident bony tuberosity connecting the Achilles tendon with the plantar fascia ligament. We performed a spatially resolved analysis of trabecular microstructure, suggesting that trabecular network was not significantly influenced by the tendon insertion. Conversely, bone beneath the attachment region showed a highly oriented canal network, aligned along the pulling direction of the tendon. Surface roughness was significantly higher at the tendon insertion with respect to nearby locations. Micro-FE simulations clarified the contributions of these different microstructural features to local stresses.