Experts weigh in on Shohei Ohtani’s elbow procedure

ST. PETERSBURG, Fla. — Although the statement released by Shohei Ohtani’s agent about his surgery did not include the phrase “Tommy John surgery,” two orthopedic surgeons who read the statement believe that was the procedure Ohtani underwent on Tuesday.

How the surgery is described is perhaps only a matter of semantics. The Angels and Ohtani’s agent previously said he had torn his ulnar collateral ligament. The statement laid out a clear timetable. Ohtani won’t pitch until 2025 but should be able to hit by the start of 2024.

Dr. Neal ElAttrache, who performed the surgery, said in a statement released Tuesday by agent Nez Balelo that the procedure was to “repair the issue at hand and to reinforce the healthy ligament in place while adding viable tissue for the longevity of the elbow.”

The doctors, neither of whom has any first-hand knowledge of the procedure outside of the statement, said it suggested a reconstruction.

“If it was just a repair, the typical timeline would be six or eight months for a pitcher, and that would be during the 2024 season,” said Dr. Joshua Dines, a sports medicine surgeon at the Hospital for Special Surgery in New York. “The fact that they’re saying the 2025 season is sort of a 16- or 18-month recovery, and that speaks more to a full Tommy John reconstruction using a graft from somewhere to make a new ligament, even if you’re repairing whatever native ligament he had.”

One particular phrase in the statement suggested that Ohtani didn’t have a mere repair, though.

“When you say that you’ve reinforced it with viable tissue, almost everybody would agree that that is not just suture or an internal brace,” Dines said. “That would be tissue, meaning a graft from somewhere else.”

Dr. Gabe Horneff, the director of the Shoulder and Elbow Fellowship at the Perelman School of Medicine at the University of Pennsylvania, also said it looked like a Tommy John surgery, based on ElAttrache’s statement.

“Based on how he phrased it, and the timeline that was proposed, I strongly suspect that he had a revision reconstruction,” Horneff said. “And then they did do the internal brace in addition to that.”

The internal brace procedure is when the surgeon adds a thick suture-like material that provides strength to the ligament. That could allow Ohtani to be back as a hitter by Opening Day 2024, which would be a faster timeline than when he had Tommy John surgery on Oct. 1, 2018. He was not in the Angels’ lineup until May 9, 2019.

“The internal brace allows him to creep up another month or two in terms of hitting because the internal brace is this high tensile suture that does protect what your soft tissue reconstruction or repair is,” Horneff said.

Any ambiguity about the precise nature of Ohtani’s surgery will certainly be cleared up when his camp provides the details to teams attempting to sign him as a free agent this winter.

Ohtani, 29, is still expected to get a record-breaking contract, although the total value will likely be less now than it would have been if he had not been hurt this season.

A handful of major league pitchers have already successfully returned from second Tommy John surgeries, including Jameson Taillon of the Chicago Cubs, Nathan Eovaldi of the Texas Rangers and Mike Clevinger of the Chicago White Sox.

The Dodgers’ Walker Buehler and the Rangers’ Jacob deGrom are the most prominent pitchers currently working their way from repeat Tommy John surgeries.

PLAN FOR PARIS

Infielder Kyren Paris will need a procedure to repair a torn ligament in his left thumb, Manager Phil Nevin said on Wednesday. Paris was hurt putting down a tag in Saturday’s game.

Nevin said Paris will be “good to go for spring training.”

Paris, 21, was just 4 for 40 in his first opportunity to play in the major leagues, but Nevin said he made a good impression with the way he adjusted in the couple of weeks he was active.

“I felt like he was making good strides with his swing, the balls he was hitting,” Nevin said. “The ball was really coming off the bat well. I love what he does on defense, his energy.”