Bautista to undergo elbow surgery next month (updated)

Closer Félix Bautista won’t pitch for the Orioles in the upcoming playoffs.

He won’t pitch in 2024, either.

Executive vice president/general manager Mike Elias confirmed this afternoon that Bautista will undergo surgery next month to repair the torn ulnar collateral ligament in his right elbow.

Dr. Keith Meister will handle the procedure in Dallas.

The club delayed its decision until allowing Bautista to rehab the injury and begin throwing again, first on flat ground and most recently against minor leaguer Ramón Rodríguez on Tuesday at Camden Yards. He threw 25 pitches in his first action against a hitter.

"That was kind of the long-term conclusion as soon as we had our arms around the injury and got the imaging and the various medical opinions," Elias said. "That said, everybody involved - and of course to Félix's credit, bless his heart - realized there might be a window to sort of keep his arm throwing, up and running, but we just ran out of time for this to be a feasible and successful option for the postseason, and it's not making sense, so we went ahead and scheduled the surgery."

Though Bautista felt fine after his live batting practice session, the Orioles determined that he wasn't equipped to resume appearing in real games next month.

"We're talking about going to play the highest level of baseball in the world here the next few weeks, and just getting him into a competitive state and a recovery state between outings, it was a pipe dream to begin with and it just seemed increasingly far-fetched," Elias said. "But I think it was responsible of everyone, including him, and admirable of him to want to try. He wanted to keep pitching, and doctors thought this might be a case where there was a glimmer of hope we could pull that off.

"I think if we had two months left, maybe we could, but we're playing a playoff game here in a week. To bum rush that, it doesn't make sense for anybody. So, we're just going to go ahead and start getting this behind us."

Bautista was one strike away from recording his 34^th save on Aug. 25 against the Rockies. A 102.3 mph fastball to Rockies’ pinch-hitter Michael Toglia missed its mark, and Bautista spun toward first base and began flexing his right hand. He walked off the mound with head athletic trainer Brian Ebel, and the club lost an All-Star and arguably the best reliever in baseball.

A contender for the Cy Young Award in the American League. A dominant specialist who provided a significant edge against other teams in the postseason.

"It's obviously really disappointing, the night he got hurt, but these things happen," said manager Brandon Hyde. "Not the first guy to have Tommy John surgery and he's going to come back better for it. But disappointed that he's not going to be with us for the postseason.

"We were pretty aware that he was going to have this type of surgery, so I just give the guy a ton of credit for doing everything he could to pitch in the postseason. Wanted to be with his teammates and pitch and be part of it. He has busted his butt since the night he got hurt just to have the chance to. We love the guy. Just shows you what kind of unbelievable teammate he is to do this, really, for his teammates, to try to contribute in the postseason. Just unfortunately, it can't happen."

Bautista went 8-2 with a 1.48 ERA and 0.92 WHIP in 56 appearances, striking out 110 batters in 61 innings. Asked how he's handling the situation, Elias said, "He's a really tough dude."

"He's been through a lot in his life where he came from, 10 years in the minors, coming out of nowhere," Elias said. "The news, when it happened and the day after it happened, we had a brief glimmer of hope that it wouldn't be torn, but when we got the MRI results and heard from the doctors, it was really disappointing for everyone, but credit to him, he got over it quickly and got back to work and immediately started focusing on the future. He's doing awesome now.

"Just bad timing for him and the team, but it's just temporary. Thank goodness we have this surgery to fix this injury, so it's just become basically a matter of time and some hard work and you're back. You see what (John) Means is doing."

Surgery was inevitable for Bautista, but the Orioles tried to get him ready for the playoff run. The condition of his elbow didn’t worsen.

"It's nothing that changed or nothing that happened in the last couple weeks since he's been throwing, other than it became evident to us that this wasn't going to get to where it needed to go in terms of his buildup and restoration of, sort of, skill to be able to go out and pitch in the playoffs, for it to be worth losing more time," Elias said. "We expect it to be a very normal, routine Tommy John."

The surgery will happen in the first or second week of October.

"He should be back to being Félix Bautista in spring training 2025, so we'll be in good shape there, long-term," Elias said. "He's going to get through this. He's got very good, healthy and work ethic otherwise, but obviously we're going to miss the hell out of the guy. Unfortunately, this has become part of our game, especially for the more elite pitchers, and it is what it is and we're rallying around him and the group.

"He's going to be with us for the playoffs, he's a huge part of our clubhouse, so it will be nice having him there."

The Orioles could match up against the Rays in the Division Series, and Bautista had a victory and four saves in five appearances against them, tossing 6 2/3 scoreless innings and striking out 11.

Yennier Cano has closed in Bautista’s absence, but not exclusively. Hyde also plays matchups, along with availability, and has gotten saves from Cionel Pérez and Tyler Wells.

Time is running short for the Orioles to set their playoff roster, with a few potential moves pending in the bullpen. A starter could shift to it with only four maximum needed in the Division Series. The club must decide whether Shintaro Fujinami’s arm outweighs his inconsistencies in the strike zone.

There's also the matter of anointing a closer for next season, and whether it impacts what the Orioles do over the winter.

"I'd be lying if I said I wasn't thinking about that in the back of my mind," Elias said, "but we're so focused on preparing for the playoffs right now, it's not something we've had meetings about or starting to look at that stuff. We're laser-focused on this playoff run."

Elias said he hasn't considered Wells for the role in 2024.

"He was almost an All-Star starter in the first half," Elias said. "Obviously, he hit a wall, however you want to put it, but was not himself in the second half. So, to take a starter and turn him into a reliever is usually something that we spend time talking about and planning. He's going to be in the bullpen for the playoffs. I don't want to speak for Brandon, but he is a closer option in the playoffs - as he proved the other night and he proved in 2021 - but we've got other guys, too.

"I think, like Brandon said, it's going to be pretty matchup-and-availability-driven. It's a lot different when you have the best closer in the game on the top of his game. You kind of build your bullpen around him, and we don't have that anymore. What we do have is a lot of really talented pitchers and some guys that are equipped to be starting pitchers that, because of the playoff format, will be in our bullpen. I actually think that's going to be nice because we have a lot of healthy starting-caliber pitchers up and running now on the team, and it's something we're going to try to lean into in the playoffs."

* The Orioles reached agreement with Bautista on guaranteed contracts for the 2024 and 2025 seasons, the latter in his first year of arbitration eligibility. Elias called it "a little bit brighter note."

"I think that's great, because he can just concentrate on his rehab and getting back on the field. He won't have any business to attend to in that time," Elias said. "We did something similar with John Means, and very happy for Félix and for us that that's out of the way."

* Kyle Bradish is starting Sunday afternoon in the final regular season game, but his outing could be shortened.

Left-hander Bruce Zimmermann is here to provide depth, Hyde said.