Arterial supply to the human anterior cruciate ligament.

The arterial supply to the anterior cruciate ligament (ACL) was prepared for study by injecting a fresh cadaver knee with an epoxy lead-oxide solution and subsequently immersing it in 10% formalin for a 2-week period. The vasculature of the ACL was exposed through dissection for examination. A second specimen was prepared similarly and was evaluated by a CAT scan. ACL vascularization arises from the middle genicular artery and vessels of the infrapatella fat pad and adjacent synovium. The artery gives rise to periligamentous vessels which form a web-like network within the synovial membrane. These periligamentous vessels give rise to penetrating branches which transversely cross the ACL and anastomose with a network of longitudinally oriented endoligamentous vessels. Terminal branches of the inferior medial and lateral genicular arteries supply the distal portion of the ACL directly. The extremities of the ACL seem to be better vascularized than the middle part, and the proximal portion seems to have a greater vascular density than the distal portion. The arteries at the ligamentous-osseous junctions of the ACL do not significantly contribute to the ligament's vascularity. Ramifications concerning the ACL's blood supply as it relates to athletic training is also discussed.