- Discussion:
- thickening of the
medial capsular ligament attached proximally to adductor tubercle of femur and distally to tibia & posterior aspect of the capsule;
- anatomically this is the third (deep) layer of the
medial compartment;
-
parts of the distal arm:
- thin superficial fascial extension
- poorly defined inferior or distal arm, which attaches distally both to sheath covering the
semimembranousus tendon;
- superior capsular arm, which is continuous w/ posterior capsule & proximal part of
oblique popliteal ligament;
- fascial covering which runs posteriorly and laterally, combining w/ part of semimembranous tendon to become oblique popliteal ligament;
- central portion which originates at the adductor tubercle and inserts on the posteromedial corner of the tibia;
- attaches to edge of posterior surface of tibia close to margin of articular surface & central to upper edge of
semimembranous tendon;
- function:
- provides static resistance to valgus loads as the knee moves into full extension;
- may act as a dynamic stabilizer (thru attachment of semimembranosus) to
valgus force as the knee moves into flexion;
- Treatment of Tears:
- indications for repair of posterior oblique ligament tears remains unclear;
- w/ associated
repairable meniscal tears, it would seem that concomitant repairs of the the P.O.L. (via
inside outside technique) is logical since this anatomy will be exposed for the meniscal repair;
- most often P.O.L. is torn from femoral origin;
- repair will involve advancement superiorly and anteriorly as it is attached to the femoral epicondyle
as well as attached to the posterior edge of the
MCL;
- finally the
semimembranousus tendon is evaluated and if found to be torn it too may be advanced anteriorly and opposed to the P.O.L. repair site;
Limits of movement in the human knee. Effect of sectioning the posterior cruciate ligament and posterolateral structures.
The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up.
The Posteromedial Corner of the Knee. Medial-Sided Injury Patterns Revisited.
The posteromedial corner revisited. An anatomical description of the passive restraining structures of the medial aspect of the human knee.
The Role of the Posterior Oblique Ligament in Controlling Posterior Tibial Translation in the Posterior Cruciate Ligament–Deficient Knee
