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Using both a direct measure of ACL linear stiffness and an in vivo magnetic resonance imaging (MRI) T<jats:sub>2<\/jats:sub>*\u2010based prediction model, we hypothesized that cartilage damage and ACL stiffness would increase over time, and that an inverse relationship between cartilage damage and ACL stiffness would emerge at a later stage of healing. After either 6, 12, or 24 weeks (w) of healing after ACL repair, ACL linear stiffness was determined from the force\u2013displacement relationship during tensile testing ex vivo and predicted in vivo from the MRI T<jats:sub>2<\/jats:sub>*\u2010based multiple linear regression model in 24 Yucatan minipigs. Tibiofemoral cartilage was graded postmortem. There was no relationship between cartilage damage and ACL stiffness at 6\u2009w (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.04;<jats:italic>p<\/jats:italic>\u2009=\u20090.65), 12\u2009w (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.02;<jats:italic>p<\/jats:italic>\u2009=\u20090.77), or when the data from all animals were pooled (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.02;<jats:italic>p<\/jats:italic>\u2009=\u20090.47). A significant inverse relationship between cartilage damage and ACL stiffness based on both ex vivo measurement (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.90;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and in vivo MRI prediction (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.78;<jats:italic>p<\/jats:italic>\u2009=\u20090.004) of ACL stiffness emerged at 24\u2009w. This result suggests that 90% of the variability in gross cartilage changes is associated with the repaired ACL linear stiffness at 6 months of healing. Clinical Significance: Techniques that provide a higher stiffness to the repaired ACL may be required to mitigate the post\u2010traumatic osteoarthritis commonly seen after ACL injury, and MRI T<jats:sub>2<\/jats:sub>* can be used as a noninvasive estimation of ligament stiffness. \u00a9 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2249\u20132257, 2019<\/jats:p>","DOI":"10.1002\/jor.24381","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T12:40:09Z","timestamp":1558701609000},"page":"2249-2257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cartilage Damage Is Related to ACL Stiffness in a Porcine Model of ACL Repair"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2821-1227","authenticated-orcid":false,"given":"Jillian E.","family":"Beveridge","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Warren Alpert Medical School of Brown University\/Rhode Island Hospital Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5834-7934","authenticated-orcid":false,"given":"Benedikt L.","family":"Proffen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic 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