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Very cold storage, repeated movement between cold and warmer environments, shaking, unsuitable solvent conditions, or high concentration can all increase the chance of visible changes

Muscle contractions from mechanical loading induce microtrauma in muscle fibers, resulting in the rupture of the extracellular matrix, basal lamina, and sarcolemma, in addition to the alteration of calcium homeostasis, which promotes changes in the cell membrane structure and permeability [48, 49]

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These factors predominantly include the frequent consumption of sugar-sweetened beverages, ultra-processed foods, and diets high in saturated fats, which promote weight gain and chronic low-grade inflammation (158)

TPLO is the gold standard for ACL surgical repair