Under The Knife Flash 6/6/23

Jacob deGrom to undergo elbow surgery

The Texas Rangers announced that Jacob deGrom will undergo elbow surgery. Initial reports are saying that he will have surgery to repair a tear in his ulnar collateral ligament. Regardless of the rest, deGrom’s season is done.

The key word here is “repair.” Colloquially, it’s used to mean fix something. Tommy John surgery fixes the torn ligament by cutting it out and reconstructing it with a transplanted tendon. In deGrom’s case, this would be a Tommy John revision, since it is his second such surgery. InternalBrace repair actually sews the ligament back together, then overlays a piece of strong fiber that keeps the repaired ligament from taking too much stress.

We don’t know yet which way the Rangers are using the word and if, as expected, deGrom goes to Rangers team ortho Keith Meister, Meister is one of few doctors that perform both techniques. The repair would have deGrom out between 9 and 12 months, and that time frame is huge. It could mean he might be ready near the start of the 2024 season. Tommy John surgery would mean he’ll miss all of the remaining ‘23 season and much or even all of ‘24.

Either way, deGrom’s contract is unlikely to be insured and if it is, it’s likely to have the elbow excepted, as deGrom previously had Tommy John surgery. The revision is no more complex, but results are “worse” in terms of return to play, largely because it is older pitchers that are more likely to walk away than do another year of rehab. Most revisions use a hamstring tendon, though I don’t know what was used in his original surgery. His previous surgeon was Dr. David Altchek of the Mets.

DeGrom had been throwing bullpens and looked normal, if not at full intensity. Sources I spoke with had seemed very positive, if cautious during the process. Even deGrom himself felt he had “turned a corner” a couple weeks back. While it’s not known what happened, it’s clear there’s a more significant tear, which could be a non-healing injury or a new sprain.

DeGrom’s contract has some health-based clauses, but aside from meeting inning thresholds, none come into play just yet. If he misses all of 2024 as well, he will have difficulty hitting the 725 inning threshold that ratchets up his 2028 option. DeGrom’s deal has a $37m AAV.

I’ll have more details in tomorrow’s UTK.