FIGURE 2.

A summary of the treatment approaches and considerations for developing a clinically viable biological therapy for the promotion of graft healing after ACLR. The ultimate goal of ACLR is to replace the tunnel graft by bone with re-establishment of direct insertion at the original ACL footprint and remodel the tendon graft mid-substances to a ligament to meet the functions of an ACL. Biologics that promote bone healing, therefore, should promote tunnel healing, while biologics that enhance angiogenesis are expected to accelerate both tunnel healing and graft remodeling. As inflammation hampers graft healing, biologics that suppress inflammation are anticipated to promote both tunnel healing and graft remodeling. Researches developing osteogenic, angiogenic, or anti-inflammatory biologicals should consider if the proposed intervention is arthroscopy compatible, supports sustainable and site-specific application, and meets quality control requirements for successful future clinical translation. Created with BioRender.com.