Atlanta Braves Blog

The Atlanta Braves blog by David O'Brien, baseball writer for The Atlanta Journal-Constitution

Braves' Beachy to have 2nd TJ surgery, but not by Dr. Andrews

PORT ST. LUCIE, Fla. – The Braves’ spring of maddening misfortune continued Thursday with the announcement that Brandon Beachy would have Tommy John elbow surgery Friday, the pitcher’s second ligament-reconstruction surgery and third overall elbow surgery in just 21 months.

The surgery will be done by Dr. Neal ElAttrache, the Dodgers team physician, rather than Dr. James Andrews, who did Beachy’s previous Tommy John surgery in June 2012 as well as his arthroscopic procedure in September to remove a bone chip. Andrews, considered a foremost practitioner of Tommy John surgery, performed the procedure Tuesday on Braves pitcher Kris Medlen, also Medlen's second TJ surgery in 41 months.

Andrews has done virtually all arm surgeries on Braves in recent memory, including both of Medlen's surgeries and both Tommy John surgeries on reliever Jonny Venters, who is currently recovering from his May 2012 procedure and hopes to join the Braves bullpen in June.

Medlen was just the 25th pitcher known to have had a second Tommy John surgery since 1999, according to research by Dodgers head athletic trainer Stan Conte, and Beachy would be the 26th. Somewhat remarkably, the Braves will have three of those 26 in their clubhouse, at various stages of recovery from the second TJ surgery.

Before Medlen and Beachy, fourteen of the previous 24 had come back to pitch in the majors, with varying degrees of success, and three more -- Venters, Randy Wolf, Todd Coffey – are nearing possible returns this season.

Oakland pitcher Jarrod Parker is expected to join the multiple-TJ surgery ranks after being diagnosed this week with a torn UCL. Parker had his previous surgery in 2009. Both Parker and Medlen had been scheduled to start opening day.

Only about 20 percent of the pitchers who’ve returned from a second Tommy John surgery have pitched again at their pre-surgery performance level, and the percentage has been higher for relievers than starters.

The announcement that Beachy would have TJ surgery was expected, as the Braves had said earlier in the week that tests showed damage to Beachy’s ulnar collateral ligament, rather than merely biceps tightness as he’d initially believed when he left his March 10 start against Philadelphia after completing only two of his scheduled four innings.

Beachy and Medlen traveled together to see Andrews earlier this week. Medlen stayed and had surgery at Andrews' clinic near Pensacola, Fla., while Beachy flew to Los Angeles to get another opinion from ElAttrache about the need for another TJ surgery.

ElAttrache concurred with the diagnosis and surgery recommendation, and Beachy decided to have him do the procedure.

Braves general manager Frank Wren said the team didn't try to influence the choice of surgeon. Both Medlen and Beachy are under one-year contracts and would remain under team contractual control in 2015, provided the Braves decide to tender them contracts after the season.

"He chose to have it out there" in Los Angeles, Wren said. “The way I look at it, this is his career. He’s got to feel confident and comfortable with how this is going to play out. And if he has a better comfort level with one doctor versus another, that’s OK. That’s all part of the healing process going forward, is that confidence. So if that’s how he feels, that’s OK....

“If they were going to someone who had more of an experimental or an odd procedure, then I think we would try to persuade them a little bit. But Dr. ElAttrache is one of the top guys, as well. And it is somewhat limiting in Medlen and Beachy both in t hat you have to go to a doctor that does the same procedure, because this procedure is not compatible with some other procedures, in a (second TJ surgery)."

Wren said this week that the Braves would evaluate their post-surgery protocol going forward. The team has followed Andrews' recommendations and not rushed pitchers back ahead of the 12-month-or-more recovery period following Tommy John surgeries, but their recent rash of re-injuries has led them to re-examine how they're doing things.

Julio Teheran is now in line to start the Braves' March 31 season-opener at Milwaukee, and be joined in the rotation for the first week by veteran Freddy Garcia, second-year left-hander Alex Wood and rookie David Hale.

Newest Brave Ervin Santana, who was to make his Grapefruit League debut Thurday, could join the rotation on or before the Braves need a fifth starter April 12, the 11th game of the season. The Braves signed the former All-Star last week to a one-year, $14.1 million free-agent contract after the Medlen and Beachy injuries.

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About the Author

David O'Brien has covered the Atlanta Braves for The Atlanta Journal-Constitution since 2002.