A young athlete (pitcher in baseball) injured the medial collateral ligament of the elbow joint while pitching 3 years ago. He was treated in a specialized hospital by replacing the ligament with an artificial fiber. It has been widely known for several decades that artificial materials in the human body cannot withstand multiple stresses and tear over time. This also happened in this case. The patient came to our clinic with a request for a solution. I performed an anatomic two-bundle replacement of the internal collateral ligament with the palmaris longus tendon. It is a complex, delicate and demanding operation that only a few specialized orthopedic surgeons perform. My experience with this type of surgery is very good.