26dkou188 10.3205/26dkou188 urn:nbn:de:0183-26dkou1884 Meeting Abstract Müller Müller Maximilian M. MM

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Deutschland

author Conner-Rilk Conner-Rilk Sebastian S

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA Medical University of Vienna, Vienna, Österreich OCM – Orthopedic Surgery Munich, München, Deutschland

author Klinger Klinger Craig E. CE

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA

author Wang Wang Jerry J

Weill Cornell Medicine, New York, USA Weill Cornell Medicine, New York, USA

author von Rehlingen-Prinz von Rehlingen-Prinz Fidelius F

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, USA

author Hingsamer Hingsamer Valentin V

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA Medical University of Vienna, Vienna, Österreich

author Shea Shea Kevin K

Stanford University School of Medicine, Stanford, USA

author DiFelice DiFelice Gregory G

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA

author Brown Brown Ryan R

Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Grossman School of Medicine, New York, USA

author Rodeo Rodeo Scott A. SA

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA

author Green Green Daniel W. DW

Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, USA

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 188 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Vordere Kreuzbandchirurgie: Rekonstruktion, Revision und Biologie Berlin 20261020 20261023 DKOU26_Abs_2339 TextObjectives and questions: Historically, the limited intrinsic healing capacity of anterior and posterior cruciate ligament (ACL and PCL) injuries has been attributed, in part, to the presumed low vascularity of these intra-articular structures and a consequent lack of reparative tissue formation. Although biomechanical and functional factors also influence healing, quantitative, region-specific comparative data on ACL versus PCL vascularity remain scarce. Accordingly, the purposes of this study were (1) to quantitatively map the regional arterial supply of the ACL and PCL in a fresh-frozen human cadaveric model across standardized anatomical regions using 7-Tesla quantitative magnetic resonance imaging (7T-qMRI), histology, and high-resolution micro–computed tomography (micro-CT), and (2) to directly compare vascular distribution patterns between the two cruciate ligaments.Material and methods: Seven fresh-frozen human cadaveric knee pairs (mean age, 41.9 ± 15.5 years) underwent limited vascular dissection and arterial cannulation. Ligament vascularity was quantified using pre- and post-contrast 7T quantitative MRI (7T-qMRI) with a volumetric interpolated breath-hold examination (VIBE) 3D T1-weighted gradient-echo sequence, and contrast enhancement served as a surrogate for arterial supply. Ligament regions were defined by relative distance from the distal insertion: zone I (>90%), zone II (75–90%), zone III (25–75%), zone IV (10–25%), and zone V (<10%). Subsequently, an algorithm-based quantitative histologic analysis of hematoxylin and eosin (H&E)–stained sections was performed for validation of 7T-qMRI measurements, and two additional specimens underwent high-resolution (98 μm) micro-computed tomography (micro-CT) for qualitative assessment of vascular architecture.Results: 7T-qMRI demonstrated distinct, region-specific arterial distribution profiles, with predominantly proximal contributions in the ACL and more distal vascularity in the PCL. In the ACL, relative contributions were 12.3% at the femoral enthesis and 87.7% at the tibial enthesis, with zone-wise contributions of 10.2% (Zone I), 25.9% (Zone II), 24.9% (Zone III), 10.3% (Zone IV), and 17.6% (Zone V). In the PCL, contributions were 23.1% at the femoral enthesis and 76.9% at the tibial enthesis, with zone-wise contributions of 9.3% (Zone I), 13.2% (Zone II), 16.7% (Zone III), 21.8% (Zone IV), and 39.6% (Zone V). Overall arterial contribution within the soft-tissue zones differed significantly between ligaments (ACL, 8.3% vs PCL, 27.1%; p = 0.016), and zone-level comparisons identified significant inter-ligament differences in Zone II and Zone IV (p = 0.046 for both).Discussion and conclusions: This study demonstrates distinct, region-specific arterial distribution patterns in the ACL and PCL. The ACL showed predominantly proximal arterial supply, whereas the PCL exhibited greater distal and overall arterial contributions. These quantitative differences in vascular organization provide a biological framework that may help explain ligament-specific healing potential. 0 0 0 0