“…In general, peri-tunnel bone loss after ACLR is commonly observed in both clinical and pre-clinical studies, which might adversely affect the tendon graft enthesis mineralization and result in a less stable surface for tendon-bone integration [ 75 , 76 ]. Based on previous studies, SMF or IONPs, delivered alone or in combination, could enhance osteogenesis, inhibit osteoclastogenesis, and enhance the stability of the bone tunnel healing surface [ [45] , [46] , [47] , 49 , 77 , 78 ]. Our study also found that IONP-Exos improved bone tunnel healing by decreasing the bone tunnel diameter and stimulating new trabecular bone formation.…”