Combined Arthroscopic Anterior Cruciate Ligament and Oblique Popliteal Ligament Reconstruction of the Knee

The oblique popliteal ligament is the largest ligamentous structure of the posterior knee capsule and serves as a primary restraint to genu recurvatum and a contributor to rotatory stability. This technical note describes an arthroscopic‐assisted method for oblique popliteal ligament reconstruction, performed as an isolated procedure or in combination with anterior cruciate ligament, posterior cruciate ligament, or multiligament knee reconstructions. Indications include symptomatic post‐traumatic genu recurvatum, posterior capsular laxity, recurrent or high‐risk anterior cruciate ligament failure associated with hyperextension, persistent posterior or rotational instability, and complex multiligament injuries. The technique uses standardized femoral and tibial tunnels; controlled posterior graft passage through posteromedial, trans‐septal, and posterolateral portals; and fixation in slight knee flexion to optimize posterior capsular tension in full extension. The procedure is designed to restore native posterior knee biomechanics while minimizing neurovascular risk. Oblique popliteal ligament reconstruction may represent a valuable adjunct in managing selected cases of knee instability characterized by hyperextension and posterior capsular deficiency.