HIF1A and neoplasm: An increase in collagen cross-linking is associated with enhanced ECM stiffness, which has been shown to facilitate cell adhesion, migration, growth, and survival.15 The roles of HIF-1α signaling on the tumor collagen microenvironment and metabolic reprogramming have been well-defined.16,17 However, a fundamental understanding of how HIF-1α signaling modulates ECM and abnormal mesenchymal cell fate decisions after musculoskeletal injury is lacking.