Sm. Howell et al., REVASCULARIZATION OF A HUMAN ANTERIOR CRUCIATE LIGAMENT GRAFT DURING THE FIRST 2 YEARS OF IMPLANTATION, American journal of sports medicine, 23(1), 1995, pp. 42-49
The blood supplies of 45 unimpinged, human anterior cruciate ligament
grafts were studied during the first 2 years of implantation. Grafts w
ere defined as unimpinged by the low signal intensity of the graft obs
erved on a sagittal proton density magnetic resonance scan. Magnetic r
esonance imaging with the intravenous contrast agent gadolinium diethy
lenetriamine pentacetic acid was used to evaluate the blood supply of
the hamstring autograft as well as the periligamentous tissues by asse
ssment of enhancement patterns after administration of the agent. The
unimpinged anterior cruciate ligament graft acquired no discernible bl
ood supply during the 2 years of implantation. The graft retained the
same hypovascular appearance as the normal posterior cruciate ligament
. In contrast, the periligamentous soft tissues were richly vasculariz
ed and covered the graft by 1 month. The viability of an unimpinged, h
uman anterior cruciate ligament graft may depend more on synovial diff
usion than on revascularization.