Shohei Ohtani has elbow surgery, with 'eye on big picture' as free-agent stakes near

Shohei Ohtani had surgery Tuesday to repair damage to his valued right arm just months before the two-way superstar opens bidding for what should be the most lucrative free agency in baseball history.

In a statement released by the Los Angeles Angels, agent Nez Balelo and orthopedist Neal ElAttrache – without mentioning the word "elbow" – said Ohtani's surgery at the Kerlan-Jobe Clinic in Los Angeles "was made with a heavy emphasis on the big picture," says Balelo. "Shohei wanted to make sure the direction taken gave him every opportunity to hit and pitch for many years to come."

Ohtani has not pitched since Aug. 23, when he left a start early and later was diagnosed with a torn ulnar collateral ligament. Ohtani suffered the same injury in 2018 and underwent Tommy John surgery that kept him off the mound for all but two games of the following two seasons.

When he fully returned, his hitting and pitching exploits earned him the 2021 American League MVP, and he's expected to earn the award again this year. But the torn UCL, coming just five months before hitting the market, clouded his future value.

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Tuesday, he underwent the procedure the industry knew was necessary, though it remains unclear whether Ohtani had a second Tommy John surgery.

"The ultimate plan after deliberation with Shohei," ElAttrache said in the statement, "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.

"I expect full recovery and he’ll be ready to hit without any restrictions come opening day of 2024 and do both (hit and pitch) come 2025.”

In today's ever-shifting world of UCL reconstruction, pitchers - and almost all are pitchers - have three choices.

One is Tommy John surgery, involving total UCL reconstruction.

The second is repairing the tear and reinforcing it with an internal brace, which allows for a quicker return and is popular with hitters requiring the surgery.

And the third is a hybrid procedure – reconstruction with a brace, ostensibly allowing greater reinforcement. That procedure has appeal for two-time Tommy John patients, for which full return to action is less likely than the 85% success rate first-time patients enjoy.

As stakes increase for pending free agents and those that invest in them, teams, agents and players have grown increasingly cagey about the nature of medical procedures. Texas Rangers ace Jacob deGrom, who was sidelined after two months of a five-year, $185 million contract, underwent a second major elbow surgery in June yet the team did not indicate whether it was another Tommy John surgery or the internal brace.