Under The Knife 8/7/26
LNPC
AARON JUDGE, OF NYY (fractured rib)
We did Judge with Wednesday’s UTK Flash (which was free, as usual) and there’s no new information so I’m going to leave it there. I’ll update it as needed, as normal.
HUNTER GREENE, SP CIN (inflamed elbow)
Hunter Greene’s season is hanging by a thread, and the timing is what makes this feel so ominous. Terry Francona saying there’s only a “slim chance” Greene pitches again isn’t simply conceding the calendar. It’s acknowledging that whatever happens next has to prioritize 2027 over squeezing a couple September starts into a lost year.
The second opinion with Dr. Neal ElAttrache is the next key step and it happened Thursday, so the Reds probably know, but we don’t just yet. Greene has already been through Tommy John surgery, and he underwent arthroscopic surgery in March to remove loose bodies from the elbow. If this somehow turns out to be another crop of loose bodies or inflammation from scar tissue, that’s still bad news. Loose bodies don’t typically recur four months after surgery unless there’s an underlying process creating them. The chips are the symptom. The question becomes what’s making the chips.
The NanoNeedle is at least part of the conversation. If imaging shows a focal area of cartilage damage or uncertainty about the health of the joint surface, it could provide valuable diagnostic information and potentially offer a treatment option. It’s far less likely to help if the problem is ligamentous or if the joint has developed more diffuse degeneration. That’s what Dr. ElAttrache will be trying to sort out.
The calendar works against every conservative option. Even a two week shutdown would push Greene into September before he could begin building back up, and no team is asking a pitcher with this history to go from flat-ground throwing to meaningful innings in the final weeks of the season. Once you accept that reality, shutting him down becomes the only sensible path.
It’s heartbreaking because Greene has ace-level ability. The velocity is elite, the fastball plays, and when he’s healthy he can dominate anyone in baseball. We’ve seen similar stories with pitchers like Noah Syndergaard and Stephen Strasburg, where repeated interruptions gradually became part of the scouting report. Greene isn’t there yet, but this is exactly why Cincinnati held onto him at the deadline. Right now, the Reds have a pitcher with extraordinary talent and a very uncertain elbow, and those two facts have become impossible to separate.
TREY YESAVAGE, SP TOR (meniscus tear)
When Trey Yesavage walked off the mound describing a “pinch” in his knee, meniscus damage was one of the key possibilities. Now we know why everyone got serious so quickly. The meniscus is the knee’s shock absorber, but it’s also a stabilizer. Pitchers don’t just stride onto a firm front leg they rotate over it while transferring hundreds of pounds of force from the ground into the baseball. When the meniscus isn’t doing its job, the entire kinetic chain gets thrown off.
Whether surgery is necessary becomes the next major question. A small tear in the right location can sometimes be managed without an operation. A displaced tear or one that causes mechanical symptoms usually can’t. If the surgeon can repair the meniscus rather than trim it, that’s generally the better long-term answer for a young pitcher, but it also means a much longer rehabilitation. Given where Toronto sits in the standings, there should be no appetite to rush him back.
What complicates this further is Yesavage’s delivery. His mechanics have always featured a lot of moving parts, significant lower-body rotation, and an unusual amount of stress on the lead leg as he braces and unwinds. Those same mechanics help create deception and stuff, but they also ask more of the knee than a cleaner, quieter delivery. This injury won’t force a wholesale rebuild, though I’d be surprised if the Blue Jays don’t spend the winter looking for ways to reduce some of those loads.
Toronto’s season has become one long exercise in finding new ways to get bad news. Every time the club seems ready to build momentum, another significant injury arrives. Even Shohei Ohtani, whose own knee has become a maintenance project, has shown that elite players can thrive while managing chronic knee issues. The difference is that Ohtani is already an established superstar with years of experience adapting around his body. Yesavage is still trying to establish himself. His talent has never been the question. Keeping him healthy long enough to use it is rapidly becoming one.
Next week could be a little odd, or not. I’m on the road, first at the White Sox Pope Hat day on Tuesday, then further afield for the rest of the week through the weekend. My guess is the wifi will be fine and you’ll get a Thursday or Friday UTK once the travel settles, along with some other interesting content upcoming. Don’t forget Injury Territory, which is free.