Evidence map›Paper›PMID 42624346›Full record

ArticleActa biomaterialia2026

Anterior cruciate ligament overuse increases collagen fibril compliance: collagen unraveling and elevated glycosaminoglycan activity in a murine model.

Kevin H Putera, Taeyong Ahn, Ben Loflin, Adam R Carter, Roufael Hanna, Ameya Belamakar, Byron Cheatham, James A Ashton-Miller, Edward M Wojtys, Stephen H Schlecht and 1 more

Abstract read
In one paragraph

Article in Acta biomaterialia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kevin H PuteraDepartment of Chemical and Biological Engineering, Monash University, Clayton, Victoria, 3800, Australia.
Taeyong AhnDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States.
Ben LoflinDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States.
Adam R CarterDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States.
Roufael HannaDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States.
Ameya BelamakarDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States.
Byron CheathamCytoViva, Inc., Auburn, AL 36832, United States.
James A Ashton-MillerDepartment of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States.
Edward M WojtysDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, 48109, United States.
Stephen H SchlechtDepartment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States; Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN, 46202, United States. Electronic address: steschle@iu.edu.
Mark M Banaszak HollDepartment of Chemical and Biological Engineering, Monash University, Clayton, Victoria, 3800, Australia; Department of Mechanical and Materials Engineering, The University of Alabama at Birmingham, Birmingham, AL, 35294, United States. Electronic address: mmbanasz@uab.edu.

Funding

New Perspectives on ACL InjuryR01AR054821 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ASHTON-MILLER, JAMES ANTHONY, WOJTYS, EDWARD M · 2007 to 2021
$3.1M
Natural Variation in the Growth and Development of the ACL ComplexR00AR070903 · NIAMS · INDIANA UNIVERSITY INDIANAPOLIS · PI SCHLECHT, STEPHEN · 2019 to 2021
$739k
NIAMS NIH HHS R00 AR070903NIAMS NIH HHS R01 AR054821
6 · The paper itself

Abstract

Data increasingly indicates that many anterior cruciate ligament (ACL) injuries are likely due to tissue damage accumulation and the gradual decrease in ACL strength and stiffness over time. Previous ex vivo experiments found molecular-level ACL damage (collagen unraveling) to be associated with increased tissue compliance at the collagen fibril-level. However, it remains unclear if this biomechanical effect is present in vivo, or what effect other modulators of tissue mechanics (e.g., glycosaminoglycans (GAGs)) have in fatigued-damaged ACL matrices. Herein, we investigated the in vivo relationship between collagen unraveling and fibril-level mechanics in response to ACL fatigue loading in a mouse model and determined whether GAGs are also involved in altering tissue mechanics in this injury scenario. Mouse ACLs were submaximally fatigue loaded in vivo and harvested after one hour of tissue recovery. Compared to their contralateral controls, fatigued ACLs showed increased collagen unraveling and elevated GAG signatures within damaged extracellular matrix (ECM) regions. These regions also exhibited higher fibril-level compliance. Spectral data indicated colocalization of unraveled collagen and GAG-rich domains. Versican, a large aggregating PG, emerged as a candidate contributor to increased GAG presence in these regions. Together, these findings suggest that fatigue-induced collagen unraveling promotes local GAG accumulation - mediated by PGs such as versican - which likely contributes to reinforcement of the ECM. STATEMENT OF SIGNIFICANCE: Outcomes from this anterior cruciate ligament (ACL) fatigue loading study provide high-resolution in vivo evidence for a structural and biochemical mechanism for the development of chronic overuse injuries. Our findings suggest that fatigue-induced tropocollagen unraveling increases collagen fibril-level tissue compliance, and that glycosaminoglycans rapidly colocalize with these damaged regions, further influencing ACL mechanics. The large aggregating proteoglycan, versican, was immunohistochemically identified as a candidate for glycosaminoglycan recruitment to the damaged extracellular matrix. Versican may be preferentially retained in domains of tropocollagen damage to facilitate the tissue remodeling response, though further research is needed to confirm this potential link.

Indexed as

Anterior Cruciate LigamentCollagenFibrillar CollagensGlycosaminoglycansAnimalsDisease Models, AnimalExtracellular MatrixMaleMiceMice, Inbred C57BLCollagenFibrillar CollagensGlycosaminoglycansAFM-IRAnterior cruciate ligamentCollagen unravelingFatigue loadingFibril complianceGlycosaminoglycansProteoglycans

Identifiers

PMID42624346
PMCPMC13660620

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.