- 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;
- attaches on the femur 7.7 mm distal and 2.9 mm anterior to the gastrocnemius tubercle
- 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 Posteromedial Corner of the Knee. Medial-Sided Injury Patterns Revisited.