Effect of femoral and tibial tunnel angle on tunnel length and aperture stress in all- epiphyseal anterior cruciate ligament reconstruction: a CT-based and finite element analysis

Abstract Background: All-epiphyseal anterior cruciate ligament reconstruction (ACLR) spares the physis in skeletally immature patients, but tunnel orientation that provides adequate length while limiting tunnel-aperture stress is unclear. This study aimed to quantify how femoral and tibial tunnel angle affect tunnel length across age groups and tunnel-aperture stress on finite element analysis (FEA).