Forbes: With Tommy John Surgery, Yankees’ Didi Gregorius Could Be Ready By All-Star Break

The New York Yankees have announced that shortstop Didi Gregorius will undergo Tommy John surgery (UCL reconstruction) and miss part, if not all, of the 2019 season.

According to reports, the tear occurred during a throw-in Game 2 of the team’s American League Division Series last Saturday in Boston. Gregorius was able to play through the injury and finish the series.

As is often the case with UCL injuries, this seems to be an acute-on-chronic situation: “That [throw] was the finishing off of something that was a sleeping giant,” general manager Brian Cashman said, as reported by ESPN. Gregorius had an asymptomatic partial ligament tear when initially acquired from the Arizona Diamondbacks in December 2014 to be Derek Jeter’s shortstop replacement.

Some of my readers may remember a previous post about pitchers suffering UCL tears and requiring Tommy John surgery, such as Los Angeles Angels star Shohei Ohtani, but it seems this injury is clearly also affecting position players as well.

In a study of more than 5,000 professional baseball players, only 3% of position players had had UCL reconstruction. But that number may be increasing as position players are forced to throw harder and over greater distances.

Nonsurgical treatment involves rest from throwing, rehabilitation and possibly a platelet-rich-plasma injection. The success rate with conservative management ranges from about 40% to 65%.

Surgical treatment, or Tommy John surgery, involves replacing the torn UCL with a tendon graft from the patient’s wrist or hamstring. Holes are drilled into the ulna and humerus bones of the elbow to accommodate the replacement graft. The graft is then shuttled through the drill holes in the ulna and docked into the humerus.

In patients who have persistent numbness or weakness, the ulnar nerve may be transposed at the same time.

The surgery takes only about 45 minutes, and the rehab is the hard part. It takes about three or four months before one can start throwing again and even longer before a player can throw seriously in a game.

Gregorius batted .268 with 27 home runs and 86 RBIs this season as a big left-handed bat in a lineup heavy with right-handers, and he will be entering the final year of his contract in 2019. One potential cause for optimism is that, as a position player, he may be able to return to play sooner than is typically expected for a pitcher. That said, I am not optimistic that he would be ready, at the earliest, until May or June.