The posterior oblique ligament (POL) is a condensation of the posteromedial knee capsule running from the posterior medial femoral condyle to the posterior medial tibial plateau and semimembranosus expansion, providing the primary posteromedial rotational stability.
Resists posteromedial tibial rotation, contributes to medial valgus stability, and is the primary passive restraint against anteromedial rotatory instability (AMRI). Acts in concert with the MCL and semimembranosus.
POL injury accompanies high-grade MCL injuries and ACL tears with medial complex involvement. The posteromedial drawer test assesses POL integrity. Repair of the POL in combined medial complex injuries improves overall medial stability beyond isolated MCL repair.
Posterior oblique ligament repair combined with ACL reconstruction in combined medial complex injuries, reducing posteromedial rotatory instability and improving overall knee stability outcomes.
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