On deciding to write on this topic, I had to limit myself severely. There are countless articles on the surgery first performed by Dr. Frank Jobe on Dodgers starting pitcher Tommy John in 1974. Here is Web MD discussing the procedure. This one is a campaign to get Dr. Jobe in the Baseball Hall Of Fame. Here is one wondering if Dr. Andrews belongs. Many articles highlight one specific player undergoing the procedure. Here is a Will Carroll article that comes closest to what I am trying to get at.
The recovery for ulnar collateral ligament replacement used to be 18 months. Now, the pitcher is often back throwing in nine to 12 months. Will Carroll writes that the Jobe clinic has a specific regimen that has the recovery time at 10 months, starting with throwing a baseball at around the six-month mark. If you read all the available information on the surgery, had relatively good recall, and enjoyed seeing some blood, you could represent an attending physician at one of the surgeries. This, however, has little to do with the Cubs.
Theo Epstein has become quite accomplished at acquiring pitchers who have had the now-commonplace surgery, almost to the point of this becoming a running gag. Why does he find them so tempting? To start to answer that, I'll rewind to last off-season. Paul Maholm was signed in Epstein's first off-season leading the Cubs. Maholm had suffered a shoulder injury in 2011, and the Pittsburgh Pirates opted to let Maholm become a free agent. With Pittsburgh, his best year had been 2008. His 2011 was progressing well, until he was injured.
The Pirates were concerned about his shoulder. Teams that seemed to be in contention for playoff spots didn't want to waste every fifth start on a guy who might not be recovered from his injury the year before. Epstein gambled on Maholm's health, realizing he didn't have many other options. Or, a whole lot to lose if Maholm had a bad season. The lefty started out the season in rather nondescript fashion, but leading up to his July trade to Atlanta, he was having a tremendous stretch, sporting a 1.00 ERA in his final seven starts for the Cubs.
The key piece coming back in the trade was Arodys Vizcaino, who was coming off of TJS in March of 2012, performed by Dr. Andrews. Atlanta made him available, in large part, due to the surgery. Not only were the Braves brass no longer sold on Vizcaino as a starter, they also feared he might suffer from a first season of reduced effectiveness. Due to the surgery, pitchers will often have a bit of a down first season back. (In the Cubs system in 2012, that was evident in the poor peripherals on Rob Whitenack. Despite Whitenack's poor record/statistics, the team still added Whitenack to the 40-man roster before the December Rule 5 draft.) A team in contention can't necessarily 'nurse' a pitcher back to health the same way a team with lower expectations can.
Epstein plucked Vizcaino 'on the cheap' as his former team considered him short-term-expendable and potentially a long-term risk due to his injury.
Using the 10-12 month timeline, Vizcaino could be almost ready for the opening of the season. However, the Cubs may well benefit from expanding his recovery time. How so? Since Vizcaino isn't being counted on for a major role, especially early in 2013, he can be stowed on the 60-day disabled list. Putting him on the 60-day DL in mid-March would take him off the 40- (and 25-) man roster, allowing for more roster flexibility. If Cubs fans have learned anything over the past 15 or so months, it has been Epstein's willingness to maneuver within and around the 40-man roster rules.
My guess is Vizcaino will start April in Mesa on the 60-day DL, and in June, begin a swing through the minor league affiliate ladder, possibly starting in Kane County. By taking the rehab tack, not only does he not take a big league roster spot, he isn't counting against the limit for the minor league squad. Pitch a couple in Kane County, try Daytona for a five inning start twice, then head to Smokies Park once. About the time a few players have left the system at the deadline, Vizcaino should be ready for Wrigley's third base dugout.
Scott Baker's injury cost the Twins a valued arm. and his surgery by Dr. David Altchek was in mid-April. Using the accepted 10-12 month timeline, he should be ready to go on or near Opening Day. Would Epstein slow-play the injury for two months to buy another 40-man slot? (What do you mean? I sound like a conspiracy theorist?) Baker represented being ready for the season opener, and would be more in line for his bonuses if he pitches more than less, presumably.
Then, the question is, does Baker qualify as a 'keep or 'trade' type of addition? If Baker pitches to what Epstein hopes to see, I expect some extension talks in or around May and June. (The team isn't required to submit extension discussions to anyone, so that we don't see articles about them doesn't mean they aren't happening.) If the team likes the pitcher and vice versa, an extension could be in line, production depending. If Baker seems to think he should get more than the team is offering, or Epstein and crew like the offer of prospects better than what they see in Baker long-term, a trade is certainly a possibility.
Josh Conway was the Cubs' fourth-round selection in last June's draft. He was a top-30 selection possibility before an injury cut his season short. His May surgery by Dr. Andrews would probably peg him for bonus time in Mesa rehabbing his arm, before a likely jump to Kane County. Conway not only slipped three rounds in the draft, he signed for an amounted under his slotted value. The Cubs brass snagged a solid starting pitching option in the fourth round, and at a discount financially on the pick. That represents a nice way to add talent.
Fans may look at Conway's (or Baker's, or Vizcaino's) numbers his first season back and be underwhelmed. That is how it works with the TJS procedure. There will be those days where the location (either in the strike zone, or in general) isn't there. That leads to the short and unimpressive stat lines that kill a pitcher's numbers. Take all of their numbers with a grain of salt.
I would be negligent if I ignored the most recent TJS addition, Korean righthander Chang-Yong Lim. I was having more trouble locating the specifics on Lim's injury and surgery. Since he was signed to a 'split contract' (Lim's amount of pay will depend on if he is pitching in the minors or the majors), and since he doesn't appear to have a date when he has to be activated to avoid nullifying the deal (Hideo Nomo's Cubs contract like that is tangentially mentioned here), Lim is free to rehab all through 2013. The Cubs benefit by not advancing him to the parent club in 2013, as he then wouldn't cost the team at 25- or 40-man spot. If he isn't moved up through the year, the 40-man Jenga can continue though next off-season without him taking up a spot. However, if ready and needed, he will be available.
This spring, you'll probably have a sports news broadcast going, and you'll hear about a young, promising pitcher making a trip to see Dr. Andrews. The Cubs front office will hear the same report. If that is a team that has playoff aspirations in 2013 and 2014, would he be possible trade bait to the Cubs? It depends on how far down the pecking order the pitcher falls in the system, and if the team has designs on a player on the Cubs' active roster approaching the deadline. Epstein's expectations for 2014 may play into the decision-making as well. If making the playoffs are front-and-center for 2014, as opposed to basic talent-acquisition, rehab additions become less likely.
And in case you're curious, I'm good with either physician being inducted into the Hall of Fame.