The posterior oblique ligament (POL) is the primary posteromedial static stabiliser of the knee, arising from the semimembranosus expansion and reinforcing the posteromedial capsule. It works with the superficial MCL to resist valgus stress and internal tibial rotation. The posteromedial corner reconstruction includes the POL when it is disrupted in combined valgus-rotation knee injuries.
| Origin | Medial femoral condyle, just distal and posterior to the adductor tubercle |
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| Insertion | Posteromedial tibia, posteromedial capsule and posterior horn of the medial meniscus, blending with the semimembranosus expansion |
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Resists valgus and internal rotation forces near full extension and reinforces the posteromedial capsule.
The POL is the key structure in posteromedial corner reconstruction and the main passive restraint against anteromedial rotatory instability. It is tightened or reconstructed using a semimembranosus advancement or a tendon graft. MRI identifies POL disruption as posteromedial soft tissue oedema and ligament discontinuity. Combined MCL and POL tears produce valgus instability at both 0 and 30 degrees of flexion. Repairing the POL in combined medial complex and ACL injuries improves stability beyond isolated MCL repair.
POL disruption requiring combined superficial MCL and POL reconstruction for valgus instability at full extension.
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