Editorial Commentary: Perfect Tunnel Position in Tommy John Surgery Is Critical for Success.

Abstract

The number of primary ulnar collateral ligament reconstructions (UCLRs) has been increasing at an alarming rate, and so has the number of revision UCLRs. Malpositioned tunnels are a technical surgical factor that causes graft failure and need for revision. Malpositioned tunnels result in a nonisometric graft. A common malposition error is to place the inferior humeral tunnel too far posterior, which causes the graft to be tight in flexion; therefore, elbow flexion will be restricted or, if flexion is forcibly obtained, the graft will be loose and nonfunctional. Revision UCLR is technically challenging, especially in the setting of malpositioned tunnels that require correction.