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Jarrod Parker, Kris Medlen face second Tommy John surgery, join short list of double recipients

Jarrod Parker's upcoming Tommy John surgery will be the second his young career. (Morry Gash/AP)Jarrod Parker's upcoming Tommy John surgery will be the second of his career. (Morry Gash/AP)

The A's made it official Monday afternoon: Jarrod Parker is headed for the second Tommy John surgery of his young career, wiping out his entire 2014 season. Parker, whose first surgery was performed in October 2009, will thus add his name to a tiny, but rapidly growing list of pitchers who have had the surgery more than once, a list that now also includes the Braves' Kris Medlen (August 2010) and may soon add Brandon Beachy (June 2012). Those players may be gone for 2014, what are their odds of contributing in 2015 and beyond?

My research has produced a list of 37 major league pitchers who have had multiple Tommy John surgeries prior to Parker and Medlen. Seven of those 37 had their second surgery in or after June 2012 and have yet to return to major league action. That leaves a data sample of 30 pitchers from which we can attempt to draw some conclusions about Parker's chances of returning to his previous form.

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That's not much to work with compared to the list of players who have had the surgery once, a list that is hundreds of names long and is thick with All-Stars and Cy Young award winners, many of whom were as good or better after having the surgery than before. To date, the most successful pitcher ever to have multiple Tommy John surgeries is Jose Rijo, but his success came almost entirely before his first surgery. Rijo pitched for 12 years in the major leagues and won 111 games before elbow problems forced him out of the game in 1995. Rijo subsequently had Tommy John surgery three times (not the often-repeated five) before returning a staggering six years later in 2001 and throwing another 94 innings across two seasons before retiring for good at the age of 37.

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The pitcher to have the most success after his second Tommy John surgery is long-time Blue Jay and current Rangers reliever Jason Frasor. Frasor had both of his surgeries before his major league debut, the first in college in 1998, which is why he wasn't drafted until the 33rd round in 1999, and the second in 2001 in A-ball in the Tigers' system. Since making his major league debut with the Blue Jays at the age of 26, however, he has appeared in 586 games, all in relief, posting a 120 ERA+ and compiling 7.6 wins above replacement, according to Baseball-Reference.com's numbers. Now 36, he's coming off a 2.57 ERA with the Rangers last year and expected to be a prominent part of their bullpen once again in 2014 alongside a more recent repeat Tommy John recipient, Joakim Soria.

There have been numerous other relief pitchers who have returned from a second Tommy John surgery to resume their careers over multiple seasons, but they were a rather undistinguished group even before their elbow problems. The list of the all-time leaders in games pitched after a second Tommy John surgery follows Frasor with Doug Brocail (288 games), Hong-Chih Kuo (218), Lance Carter (175) and Chad Fox (134), while Jason Isringhausen pitched in 103 games after having the surgery for a third time in June 2009 at the age of 36.

Soria and the Dodgers' Brian Wilson, both of whom had their first surgery in 2003, well before their major league debuts, and their second surgery in April 2012, present more compelling cases. Both had emerged as elite, All-Star closers before their second surgery, and both made promising returns late last year and stand to play key rolls in their respective teams' bullpens in the coming season. Wilson re-signed with the Dodgers as a set-up man for $10 million after allowing just one run in 19 2/3 innings between the regular and postseasons last year. Soria struck out 28 men in 23 2/3 innings in his return last year and could wind up as the Rangers' closer, a role he is competing for in camp with first-time Tommy John recipient Neftali Feliz, who is at a similar stage of his comeback.

For Parker's and Medlen's returns to be considered a success, however, they'd have to come back as starters, and the history of starting pitchers returning from a second Tommy John surgery is far shorter. In fact, second on the list of most starts after a second Tommy John surgery is Kuo, who made just 14 and had his greatest success as a left-handed reliever for the Dodgers. Once again, Parker and Medlen can find greater inspiration on the field than in the history books, as the man ahead of Kuo on that list is the Red Sox's Chris Capuano.

Like Soria and Wilson, Capuano had his first Tommy John surgery before his major league debut, that coming in 2002 when he was in the Diamondbacks' minor league system. After being traded to the Brewers in December 2003 (in the deal which sent Richie Sexson to Arizona and Lyle Overbay to Milwuakee), Capuano emerged as a solid part of the Brewers' rotation and made the All-Star team in 2006 at the age of 27, but he had to have the surgery redone in May 2008. Capuano didn't return to the majors until 2010, doing so largely in relief for the Brewers, but he showed signs of his previous form, returned to starting with the Mets in 2011, and has since found a role as something of an innings-eater and utility pitcher for the Dodgers and, potentially, the Red Sox. Since his second surgery, Capuano, who is now 35, has made 93 starts, 84 of them coming in the last three seasons, and though he has posted an adjusted ERA below league average over that span, his peripherals have actually improved slightly relative to his pre-surgery numbers.

Yes, that's the big success story among starting pitchers who have had multiple Tommy John surgeries, but then, the list of such pitchers is hardly star studded. After Rijo, Randy Wolf, whose second surgery took place in October 2012 and who is now attempting his comeback as a 37-year-old non-roster invitee with the Mariners, is the most accomplished starting pitcher on the list. After Wolf, you get into the likes of Victor Zambrano, Darren Dreifort, and Steve Ontiveros, the last of whom became the first major leaguer to have the surgery a second time in June 1996, didn't return to the majors until 2000, when he was 39, and threw just 5 1/3 more innings before returning to the minors for good.

That list may seem damning, but those pitchers were all disappointments or in decline before their second Tommy John surgery. It's important to note that having Tommy John surgery, spending roughly a calendar year rehabilitating from it, pitching enough to require a second surgery, and then rehabbing from that is something that happens over several years. As a result, many of these pitchers would have been on the down-side of their careers by the time they returned from their second surgery, anyway. That's why Frasor, who had both surgeries in his early twenties, leads the pack by so much (nearly 300 games over Brocail with more than 60 percent more wins above replacement than runner-up Kuo).

That's also why the most telling cases may be those that are on-going. Capuano provides hope for starting pitchers like Parker and Medlen having a second Tommy John surgery, but even more compelling are the pending returns of the Blue Jays' Kyle Drabek, the Diamondbacks' Daniel Hudson, the Padres' Cory Luebke, and Parker and Medlen themselves. Drabek is 26, the same age Parker will be when he attempts his comeback next season. Drabek returned to the mound late last year, and could crack the Blue Jays' rotation at some point this year. Hudson is 27 and could return in the second half of the coming season having had his second surgery in June of last year. Luebke just had his second surgery in February, so he won't return until next season when he'll be 30, but he'll do so sporting a career ERA+ of 111 in 25 starts and 30 relief appearances. Soria won't turn 30 until May, and while Wilson will be 32 on Sunday, he was extremely impressive down the stretch for the Dodgers last year.

Then there are those Braves pitchers. Medlen will be 29 when he returns next year, the same age that teammate and fellow two-time TJ recipient Jonny Venters will be when he attempts his comeback this season. If Beachy goes under the knife, he'll be 28 when he makes it back.

Of the 39 major league pitchers in my data to require multiple Tommy John surgeries (a number that now includes Parker and Medlen), 14 of them have had their second surgery in the last four years. That's more than a third of the sample. As a result, what we know about a pitcher's ability to come back from a second Tommy John surgery, particularly as a starter, could be far greater when Parker and Medlen are on the verge of a return next spring, than it is now, though that may be of little comfort to Parker and Medlen, the A's and the Braves, and their fans.
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