ArticleJournal of experimental orthopaedics2022
Differential regional perfusion of the human anterior cruciate ligament: quantitative magnetic resonance imaging assessment.
Article in Journal of experimental orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Differential Arterial Supply of the ACL and PCL Revealed by 7T-qMRI, Histology, and Micro-CT.Orthopaedic journal of sports medicine · 2026Article
- Primary versus rerupture of the anterior cruciate ligament: rupture site patterns and graft elongation-a systematic review and meta-analysis.Knee surgery & related research · 2026Review
- Higher arterial supply in the distal quadriceps tendon: Results from 7-Tesla quantitative magnetic resonance imaging, histology and high-resolution computed tomography.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Greater medial arterial supply revealed by 7-Tesla quantitative magnetic resonance imaging, histology and high-resolution computed tomography of the patellar tendon.Journal of experimental orthopaedics · 2026Article
- Suture-augmented anterior cruciate ligament repair leads to comparable short-term function but a modestly higher re-rupture risk than anterior cruciate ligament reconstruction: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2025Review
- Research progress and clinical application of all-inside reconstruction techniques: narrative review.Frontiers in surgery · 2025Review
- Regenerative Anterior Cruciate Ligament Healing in Youth and Adolescent Athletes: The Emerging Age of Recovery Science.Journal of functional morphology and kinesiology · 2024Review
- Spontaneous healing of a ruptured anterior cruciate ligament: a case series and literature review.Journal of experimental orthopaedics · 2023Review
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Authors and funding
8 authors at 3 institutions in 1 country.
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Abstract
purposeSurgical reconstruction is the current standard for ACL rupture treatment in active individuals. Recently, there is renewed interest in primary repair of proximal ACL tears. Despite this, ACL biology and healing potential are currently not well understood. Vascularity is paramount in ACL healing; however, previous ACL vascularity studies have been limited to qualitative histological and dissection-based techniques. The study objective was to use contrast-enhanced quantitative-MRI to compare relative perfusion of proximal, middle, and distal thirds of the in situ ACL. We hypothesized perfusion would be greatest in the proximal third.
methodsFourteen cadaveric knees were studied (8 females, 6 males), age 25-61 years. Superficial femoral, anterior tibial, and posterior tibial arteries were cannulated; without intraarticular dissection. Contrast-enhanced quantitative-MRI was performed using a previously established protocol. ACL regions corresponding to proximal, middle, and distal thirds were identified on sagittal-oblique pre-contrast images. Signal enhancement (normalized to tibial plateau cartilage) was quantified to represent regional perfusion as a percentage of total ACL perfusion. Comparative statistics were computed using repeated measures ANOVA, and pairwise comparisons performed using the Bonferroni method.
resultsRelative perfusion to proximal, middle, and distal ACL zones were 56.0% ±17.4%, 28.2% ±14.6%, and 15.8% ±16.3%, respectively (p = 0.002). Relative perfusion to the proximal third was significantly greater than middle (p = 0.007) and distal (p = 0.001). No statistically relevant difference in relative perfusion was found to middle and distal thirds (p = 0.281). Post-hoc subgroup analysis demonstrated greater proximal perfusion in males (66.9% ± 17.3%) than females (47.8% ± 13.0%), p = 0.036.
conclusionUsing quantitative-MRI, in situ adult ACL demonstrated greatest relative perfusion to the proximal third, nearly 2 times greater than the middle third and 3 times greater than the distal third. Knowledge of differential ACL vascular supply is important for understanding pathogenesis of ACL injury and the process of biological healing following various forms of surgical treatment.
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