The Cubs announced Wednesday that Yu Darvish had undergone a minor elbow procedure in Dallas, news that was significantly less jarring since he’s already been shut down for the season. After receiving a second opinion from renowned orthopedic surgeon Dr. James Andrews, Darvish had an arthroscopic debridement performed by Dr. Keith Meister, the Rangers’ team doctor who is very familiar with Darvish and had previously administered his cortisone injection.
#Cubs Darvish underwent an arthroscopic debridement on his right elbow today in Dallas. He's expected to be ready for spring training
— Carrie Muskat (@CarrieMuskat) September 12, 2018
While we don’t know exactly what the procedure entailed, debridement is the removal of damaged tissue and/or foreign objects from a wound or joint in order to promote healing. In the case of the elbow, this most commonly involves removing bone spurs and/or other loose bodies, but could also include fenestration of the olecranon fossa (the thick, bony portion of the ulna that forms the “point” of the elbow).
Some of this may sound familiar to CI readers who read the explanation of Darvish’s stress reaction diagnosis, but I’ll offer a nutshell version here. His issues were caused by an inability to form new bone at the same rate it was being broken down by the stress of pitching, hence the recurring elbow pain. Treatment is often non-surgical, but it sounds like the second opinion said otherwise. And when Dr. Andrews recommends something, you do it.
The architects and Feldco employees among you may know a little something about “fenestration,” but Darvish’s deal has nothing to do with the arrangement of windows and doors. Fenestration of the olecranon fossa involves creating a new “window” in the bone and is gaining popularity as a treatment for osteoarthritis. While the elbow is not as common a location for arthritis because of its strong structure and lack of constant load bearing, pitchers are at much greater risk due to the nature of their exertions.
Now, this isn’t saying that Darvish has arthritis, though it’s certainly not out of the question given his career. It’s also reasonable to believe the Venn diagram of treatment for various elbow issues would feature quite a bit of overlap. As such, know that Dr. Meister at least performed a little clean-up on the joint in order to ensure full health.
Due to the minimally invasive nature of the surgery, the Cubs have every expectation that Darvish will be fully healed by the start of spring training. It’s even possible that he’ll actually make a quicker recovery than he would have otherwise, since the non-surgical treatment calls for a minimum eight-week throwing cessation. Of course, even pitchers who’ve experienced no health setbacks can take longer breaks than that in the offseason.
Regardless of the finer details of the procedure and what precipitated it, the whole point is that Darvish should finally be all fixed up. And if it indeed went well, there will likely be ancillary psychological benefits. Being pain-free, along with both the desire and ability to prove people wrong, could really fuel the pitcher next season.