{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:31:30Z","timestamp":1787869890279,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to quantitatively assess relative arterial contributions to the quadriceps tendon (QT) using 7\u2010Tesla quantitative magnetic resonance imaging (7T\u2010qMRI), histology and high\u2010resolution computed tomography (micro\u2010CT) in a fresh\u2010frozen human cadaveric model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six human cadaveric knee pairs were obtained (mean age: 43 years; range: 23\u201361 years). Pre\u2010 and post\u2010contrast 7T\u2010qMRI scans were performed to quantify tendonous vascularity. Subsequent algorithm\u2010based quantitative histologic analysis was performed using hematoxylin and eosin staining, with validation by CD31 immunohistochemistry. Qualitative analysis was performed on two additional knee specimens using 98\u2009\u03bcm micro\u2010CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The distal QT demonstrated higher median arterial contributions versus central and proximal regions (distal, 47.4% [interquartile range: 30.8%\u201364.1%]; central, 28.6% [20.4%\u201341.5%]; proximal, 11.6% [8.7%\u201318.4%]), with significantly greater contributions distally versus proximally (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). These findings aligned with the sagittal sub\u2010analysis (deep\u2010proximal 17.2\u2009\u00b1\u200919.3% vs. deep\u2010distal 43.4\u2009\u00b1\u200920.3%; Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.32;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.050). Histologic analysis (interobserver\u2010reliability:\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.95) corroborated the MRI results (distal QT, 43.5\u2009\u00b1\u20097.9%; central, 30.7\u2009\u00b1\u20096.4%; proximal, 25.8\u2009\u00b1\u20094.1%), with significant differences between distal and both proximal (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20092.81;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and central (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012) regions. The deep layer was found to have significantly higher arterial contributions (61.6\u2009\u00b1\u200914.2%) versus the superficial layer (38.4\u2009\u00b1\u200914.2%) (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). The medial and lateral QT demonstrated lower arterial contributions versus middle QT (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.96\u20131.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.050).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>7T\u2010qMRI and algorithm\u2010based histological analysis of arterial QT contributions revealed significantly greater arterial contributions in the distal compared to the proximal as well as in the deep compared to the superficial region. While the central region demonstrated higher arterial contributions than the medial and lateral aspects, these differences were not statistically significant. Given that the majority of injuries affect the distal and central portions of the QT, these findings reinforce the rationale for direct tendon\u2010to\u2010bone repair; however, clinical studies are necessary to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, cadaveric study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70253","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T10:36:59Z","timestamp":1766745419000},"page":"1131-1140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Higher arterial supply in the distal quadriceps tendon: Results from 7\u2010Tesla quantitative magnetic resonance imaging, histology and high\u2010resolution computed tomography"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6456-9518","authenticated-orcid":false,"given":"Maximilian M.","family":"Mueller","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"},{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology BG Klinikum Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-8276","authenticated-orcid":false,"given":"Craig E.","family":"Klinger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-6433","authenticated-orcid":false,"given":"Sebastian","family":"Conner\u2010Rilk","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"},{"name":"Medical University of Vienna Vienna Austria"},{"name":"OCM \u2013 Orthopedic Surgery Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Lab Medicine Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Shea","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Stanford University School of Medicine Stanford California 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