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In Situ Characterization Reveals an Impaired Fibril Response to Loading Following Unloading during Early Achilles Tendon Healing

Silva Barreto, Isabella LU orcid ; Sharma, Kunal LU orcid ; Pierantoni, Maria LU orcid ; Alim, Md Abdul ; Diaz, Ana ; Eliasson, Pernilla and Isaksson, Hanna LU orcid (2026) In ACS Biomaterials Science and Engineering 12(4). p.2189-2200
Abstract

The Achilles tendon is the most frequently injured tendon in humans. Despite extensive research to understand its healing, there are still no clear rehabilitation guidelines to ensure full recovery and prevent reruptures. This could partly be due to limited understanding of how loading during tendon healing affects the multiscale mechanical response and in particular the nanoscale. We combined synchrotron small-angle X-ray scattering mapping with in situ tensile stress relaxation of early healing (1-, 2-, and 3 weeks) rat Achilles tendons subjected to either full activity or immobilization. Initially, in vivo unloading resulted in a similar collagen fibril structure and spatial distribution, but then, as healing progressed, the unloaded... (More)

The Achilles tendon is the most frequently injured tendon in humans. Despite extensive research to understand its healing, there are still no clear rehabilitation guidelines to ensure full recovery and prevent reruptures. This could partly be due to limited understanding of how loading during tendon healing affects the multiscale mechanical response and in particular the nanoscale. We combined synchrotron small-angle X-ray scattering mapping with in situ tensile stress relaxation of early healing (1-, 2-, and 3 weeks) rat Achilles tendons subjected to either full activity or immobilization. Initially, in vivo unloading resulted in a similar collagen fibril structure and spatial distribution, but then, as healing progressed, the unloaded group exhibited more alterations in tissue distribution. While no clear differences were observed at the tissue scale, unloading clearly altered the nanoscale mechanical response already after 1 week of healing. Unloading led to an impaired nanoscale response, characterized by higher spatial variations, less fibril recruitment, and capacity for elongation. This indicates that the nanoscale of healing tendons is more susceptible to changes in the loading environment compared to the tissue scale. These insights contribute to a better understanding of the effects of in vivo loading on multiple length scales of the healing Achilles tendon.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
collagen, mechanics, nanoscale, small-angle X-ray scattering
in
ACS Biomaterials Science and Engineering
volume
12
issue
4
pages
12 pages
publisher
The American Chemical Society (ACS)
external identifiers
  • pmid:41903210
  • scopus:105035635004
ISSN
2373-9878
DOI
10.1021/acsbiomaterials.5c01976
language
English
LU publication?
yes
id
c4c21db0-7415-40ea-ab8e-2f0a4e6b340a
date added to LUP
2026-06-24 12:15:35
date last changed
2026-09-04 00:16:33
@article{c4c21db0-7415-40ea-ab8e-2f0a4e6b340a,
  abstract     = {{<p>The Achilles tendon is the most frequently injured tendon in humans. Despite extensive research to understand its healing, there are still no clear rehabilitation guidelines to ensure full recovery and prevent reruptures. This could partly be due to limited understanding of how loading during tendon healing affects the multiscale mechanical response and in particular the nanoscale. We combined synchrotron small-angle X-ray scattering mapping with in situ tensile stress relaxation of early healing (1-, 2-, and 3 weeks) rat Achilles tendons subjected to either full activity or immobilization. Initially, in vivo unloading resulted in a similar collagen fibril structure and spatial distribution, but then, as healing progressed, the unloaded group exhibited more alterations in tissue distribution. While no clear differences were observed at the tissue scale, unloading clearly altered the nanoscale mechanical response already after 1 week of healing. Unloading led to an impaired nanoscale response, characterized by higher spatial variations, less fibril recruitment, and capacity for elongation. This indicates that the nanoscale of healing tendons is more susceptible to changes in the loading environment compared to the tissue scale. These insights contribute to a better understanding of the effects of in vivo loading on multiple length scales of the healing Achilles tendon.</p>}},
  author       = {{Silva Barreto, Isabella and Sharma, Kunal and Pierantoni, Maria and Alim, Md Abdul and Diaz, Ana and Eliasson, Pernilla and Isaksson, Hanna}},
  issn         = {{2373-9878}},
  keywords     = {{collagen; mechanics; nanoscale; small-angle X-ray scattering}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{2189--2200}},
  publisher    = {{The American Chemical Society (ACS)}},
  series       = {{ACS Biomaterials Science and Engineering}},
  title        = {{In Situ Characterization Reveals an Impaired Fibril Response to Loading Following Unloading during Early Achilles Tendon Healing}},
  url          = {{http://dx.doi.org/10.1021/acsbiomaterials.5c01976}},
  doi          = {{10.1021/acsbiomaterials.5c01976}},
  volume       = {{12}},
  year         = {{2026}},
}