Enthesis Explained

Enthesis

The enthesis (plural entheses) is the connective tissue between tendon or ligament and bone.[1]

There are two types of entheses: Fibrous entheses and fibrocartilaginous entheses.[2] [3]

In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone.

In a fibrocartilaginous enthesis, the interface presents a gradient that crosses four transition zones:[4]

  1. Tendinous area displaying longitudinally oriented fibroblasts and a parallel arrangement of collagen fibres
  2. Fibrocartilaginous region of variable thickness where the structure of the cells changes to chondrocytes
  3. Abrupt transition from cartilaginous to calcified fibrocartilage—often called 'tidemark' or 'blue line'
  4. Bone

Clinical significance

A disease of the entheses is known as an enthesopathy or enthesitis.[5]

Enthetic degeneration is characteristic of spondyloarthropathy and other pathologies.

The enthesis is the primary site of disease in ankylosing spondylitis.

Society and culture

Bioarchaeology

Entheses are widely recorded in the field of bioarchaeology where the presence of anomalies at these sites, called entheseal changes, has been used to infer repetitive loading to study the division of labour in past populations.[6] Several different recording methods have been proposed to record the variety of changes seen at these sites.[7] [8] [9] [10] [11] [12] [13] [14] [15] However, research has shown that, whichever recording method is used, entheseal changes occur more frequently in older individuals.[16] [17] [18] [19] Research demonstrates that diseases, such as ankylosing spondylitis and calcific tendinitis,[20] also have to be taken into consideration. Experimental studies have demonstrated how loading history (physical activity) can increase the relative size of muscle attachment sites.[21] [22] [23] [24]

History

"Enthesis" is rooted in the Ancient Greek word, "ἔνθεσις" or "énthesis," meaning “putting in," or "insertion." This refers to the role of the enthesis as the site of attachment of bones with tendons or ligaments. Relatedly, in muscle terminology, the insertion is the site of attachment at the end with predominant movement or action (opposite of the origin). Thus the words (enthesis and insertion [of muscle]) are proximal in the semantic field, but insertion in reference to muscle can refer to any relevant aspect of the site (i.e., the attachment per se, the bone, the tendon, or the entire area), whereas enthesis refers to the attachment per se and to ligamentous attachments as well as tendinous ones.

See also

External links

Further reading

Notes and References

  1. Web site: enthesis. https://archive.today/20120205102809/http://www.medcyclopaedia.com/library/topics/volume_iii_1/e/enthesis.aspx. dead. 2012-02-05. GE. Medcyclopaedia.
  2. Book: Thomopoulos S, Birman V, Genin G . Structural Interfaces and Attachments in Biology . New York . Springer . 2012 . 9781461433163 . thomopoulos .
  3. Rothrauff BB, Tuan RS . Cellular therapy in bone-tendon interface regeneration . Organogenesis . 10 . 1 . 13–28 . January 2014 . 24326955 . 4049890 . 10.4161/org.27404 .
  4. Genin GM, Thomopoulos S . The tendon-to-bone attachment: Unification through disarray . Nature Materials . 16 . 6 . 607–608 . May 2017 . 28541313 . 5575797 . 10.1038/nmat4906 . 2017NatMa..16..607G . geninthomopoulos .
  5. Benjamin M, Toumi H, Ralphs JR, Bydder G, Best TM, Milz S . Graeme Bydder . Where tendons and ligaments meet bone: attachment sites ('entheses') in relation to exercise and/or mechanical load . Journal of Anatomy . 208 . 4 . 471–490 . April 2006 . 16637873 . 2100202 . 10.1111/j.1469-7580.2006.00540.x .
  6. Book: A Companion to Paleopathology. Jurmain R, Cardoso FA, Henderson C, Villotte S . 2011-01-01. Wiley-Blackwell. 9781444345940. Grauer AL . 531–552. en. 10.1002/9781444345940.ch29.
  7. Hawkey DE, Merbs CF . 1995-12-01. Activity-induced musculoskeletal stress markers (MSM) and subsistence strategy changes among ancient Hudson Bay Eskimos. International Journal of Osteoarchaeology. en. 5. 4. 324–338. 10.1002/oa.1390050403. 1099-1212.
  8. Henderson CY, Mariotti V, Pany-Kucera D, Villotte S, Wilczak C . 2013-03-01. Recording Specific Entheseal Changes of Fibrocartilaginous Entheses: Initial Tests Using the Coimbra Method. International Journal of Osteoarchaeology. en. 23. 2. 152–162. 10.1002/oa.2287. 1099-1212. 10316/44423. 145571511 . free.
  9. Henderson CY, Mariotti V, Pany-Kucera D, Villotte S, Wilczak C . 2016-09-01. The New 'Coimbra Method': A Biologically Appropriate Method for Recording Specific Features of Fibrocartilaginous Entheseal Changes. International Journal of Osteoarchaeology. en. 26. 5. 925–932. 10.1002/oa.2477. 1099-1212. 10316/44421. free.
  10. Mariotti V, Facchini F, Belcastro MG . Enthesopathies--proposal of a standardized scoring method and applications . Collegium Antropologicum . 28 . 1 . 145–159 . June 2004 . 15636072 .
  11. Mariotti V, Facchini F, Giovanna Belcastro M . The study of entheses: proposal of a standardised scoring method for twenty-three entheses of the postcranial skeleton . Collegium Antropologicum . 31 . 1 . 291–313 . March 2007 . 17598416 .
  12. Web site: Villotte S . Practical protocol for scoring the appearance of some fibrocartilaginous entheses on the human skeleton . en.
  13. Villotte S, Castex D, Couallier V, Dutour O, Knüsel CJ, Henry-Gambier D . Enthesopathies as occupational stress markers: evidence from the upper limb . American Journal of Physical Anthropology . 142 . 2 . 224–234 . June 2010 . 20034011 . 10.1002/ajpa.21217 .
  14. Villotte S, Assis S, Cardoso FA, Henderson CY, Mariotti V, Milella M, Pany-Kucera D, Speith N, Wilczak CA, Jurmain R . 6 . In search of consensus: Terminology for entheseal changes (EC) . International Journal of Paleopathology . 13 . 49–55 . June 2016 . 29539508 . 10.1016/j.ijpp.2016.01.003 . 10316/44443 . 3902457 .
  15. Karakostis . Fotios Alexandros . Lorenzo . Carlos . 2016 . Morphometric patterns among the 3D surface areas of human hand entheses . American Journal of Biological Anthropology . en . 160 . 4 . 694–707 . 10.1002/ajpa.22999. 27166777 .
  16. Cardoso FA, Henderson C . 2013-03-01. The Categorisation of Occupation in Identified Skeletal Collections: A Source of Bias?. International Journal of Osteoarchaeology. en. 23. 2. 186–196. 10.1002/oa.2285. 1099-1212. 10316/21142. free.
  17. Michopoulou E, Nikita E, Valakos ED . Evaluating the efficiency of different recording protocols for entheseal changes in regards to expressing activity patterns using archival data and cross-sectional geometric properties . American Journal of Physical Anthropology . 158 . 4 . 557–568 . December 2015 . 26239396 . 10.1002/ajpa.22822 . free .
  18. Milella M, Giovanna Belcastro M, Zollikofer CP, Mariotti V . The effect of age, sex, and physical activity on entheseal morphology in a contemporary Italian skeletal collection . American Journal of Physical Anthropology . 148 . 3 . 379–388 . July 2012 . 22460619 . 10.1002/ajpa.22060 .
  19. Henderson CY, Mariotti V, Santos F, Villotte S, Wilczak CA . 2017-06-20. The new Coimbra method for recording entheseal changes and the effect of age-at-death. BMSAP. 29. 3–4. en. 140–149. 10.1007/s13219-017-0185-x. 0037-8984. 10316/44430. 29420179. free.
  20. Henderson CY . Do diseases cause entheseal changes at fibrous entheses? . International Journal of Paleopathology . 3 . 1 . 64–69 . March 2013 . 29539362 . 10.1016/j.ijpp.2013.03.007 . free . 10316/44415 . 3916560 .
  21. Karakostis FA, Jeffery N, Harvati K . Experimental proof that multivariate patterns among muscle attachments (entheses) can reflect repetitive muscle use . Scientific Reports . 9 . 1 . 16577 . November 2019 . 31719626 . 6851080 . 10.1038/s41598-019-53021-8 . 2019NatSR...916577K .
  22. Karakostis FA, Wallace IJ, Konow N, Harvati K . Experimental evidence that physical activity affects the multivariate associations among muscle attachments (entheses) . The Journal of Experimental Biology . 222 . Pt 23 . jeb213058 . December 2019 . 31712353 . 6918778 . 10.1242/jeb.213058 .
  23. Castro AA, Karakostis FA, Copes LE, McClendon HE, Trivedi AP, Schwartz NE, Garland T . Effects of selective breeding for voluntary exercise, chronic exercise, and their interaction on muscle attachment site morphology in house mice . Journal of Anatomy . 240 . 2 . 279–295 . February 2022 . 34519035 . 10.1111/joa.13547 . 8742976 .
  24. Karakostis . Fotios Alexandros . Wallace . Ian J. . 2023-01-31 . Climbing influences entheseal morphology in the humerus of mice: An experimental application of the VERA methodology . American Journal of Biological Anthropology . 181 . en . 130–139 . 10.1002/ajpa.24700 . 256486347 . 2692-7691. free .

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