Palmaris Longus Tendon

• Dr. Ahmad’s preferred graft choice when it is present and of adequate size.
• 20% of people do not have a palmaris and a small percentage of patients will have a small palmaris.
• The palmaris longus has no essential function and can be taken from the throwing arm without future compromise to throwing ability.
• If the palmaris is absent or small, a gracilus tendon from the knee is used

Gracilis Tendon

• Used if the palmaris is too small or not present, second Tommy John Surgery, or occasionally if UCL tear is associated with calcification within the ligament.
• Part of the hamstring muscle group.
• Gracilus commonly used for revisions 
• Gracilus tendon often used in ACL Reconstructions (knee ligament)
• No significant observed compromise to knee function for pitching

(Dr. Ahmad has pitchers throwing over 100mph in MLB following UCL recon with Gracilus tendon graft)

• Harvested through a small incision in the front of the knee