The arcuate popliteal ligament is a Y-shaped thickening of the posterolateral knee capsule. Its stem arises from the apex (styloid process) of the fibular head and it arches over the popliteus tendon as it emerges from the joint, blending with the posterior capsule. Together with the lateral collateral ligament, popliteus tendon and popliteofibular ligament it forms the posterolateral corner of the knee.
| Origin | Apex (styloid process) of the head of the fibula |
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| Insertion | Posterior knee capsule: one limb arches medially over the popliteus tendon toward the posterior intercondylar area, the other runs up toward the lateral femoral condyle |
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Reinforces the posterolateral capsule and helps resist varus and external rotation of the tibia.
The arcuate sign (avulsion fracture of the fibular styloid) on plain radiographs is a highly specific indicator of posterolateral corner injury and should prompt MRI of the LCL, popliteus tendon, and popliteofibular ligament. Its identification at the time of multiligament knee injury ensures the posterolateral corner is not missed and left unrepaired. In anatomical PLC reconstruction the LCL, popliteus tendon and popliteofibular ligament are reconstructed, and the arcuate ligament is reinforced indirectly.
Fibular styloid avulsion of the arcuate ligament in posterolateral corner injuries, the radiographic arcuate sign indicating high probability of complete posterolateral corner disruption.
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