There’s never been more uncertainty about Los Angeles Angels two-way standout Shohei Ohtani’s future.

Following the World Series, Ohtani, a Japanese star, will be a free agent and ready to accept an extraordinary contract offer following another fantastic season in which he led the American League with 44 home runs.

As a contemporary Babe Ruth, Ohtani is a marvel who excels both at the plate and on the mound. His latest surgery makes determining his value even more challenging given his two-way talent.

Ohtani tore his ulnar collateral ligament on August 23 and had surgery on his right elbow on September 19, the second procedure of his career.

Dr. Neal ElAttrache gave details on the surgery in a statement from Ohtani’s representative, although he did not specify that Ohtani had another Tommy John treatment.

“After careful consideration and discussion with Shohei, the final plan was to address the current problem, strengthen the intact healthy ligament, and add healthy tissue to extend the life of the elbow,” ElAttrache stated. “I anticipate a full recovery, and he’ll be ready to pitch in 2025 as well as hit without any limitations come Opening Day of 2024.”

According to The Associated Press, ElAttrache also carried out Ohtani’s Tommy John surgery on October 1, 2018.

Fox News Digital spoke with Dr. Christopher Ahmad, chief of sports medicine at NewYork-Presbyterian/Columbia University Irving Medical Center, regarding a UCL tear, available surgical alternatives, and the potential effects of a second elbow operation on the healing process.

“If it’s not a revision, it’s very typical to hear that the ligament was reconstructed; that’s Tommy John surgery,” Ahmad told Fox News Digital. “It’s not clear what the specifics of the surgery are.” “When the native ligament is fixed but not replaced, this is another common scenario. No fresh tissue was inserted. After it’s fixed, you receive an internal brace. It’s a rather typical procedure.

“When I learn that something was fixed during a revision, but new tissue was added, I’m not sure what that new tissue is. Is the new tissue a graft intended to support a portion of the torn ligament? Additionally, using an internal brace is a standard method of managing a revision, or second operation. The graft can be repaired if it was torn during the initial Tommy John surgery, and an internal brace can then be used to protect it. An excellent way to describe the internal brace is as a tool that functions similarly to a seatbelt. Since a seatbelt provides protection, wearing one enables both a quicker healing process and the formation of new tissue.

Even though second elbow injuries in athletes are not unusual, they do present several possibilities for the kind of operation they can have.

“Reinjuring that ligament is a possibility if you have had reconstruction. Additionally, Ahmad stated that the type of treatment chosen will depend on the nature of the ligament injury if it is reinjured.

It is frequently possible to heal a localized area of harm to the previous surgical reconstruction. And when we say “repair,” we mean to stitch it back together. Once the internal brace device is fitted, patients can resume playing at an extremely high level.

“If the repaired tissue that sustains further damage is too severely damaged, to the point of being blown up or even shredded, it cannot be reliably repaired by sewing.” Additionally, there is a greater chance of success in that case with a second Tommy John procedure known as revision reconstruction.”

Now that Ohtani is getting ready to hit free agency, the concern is whether another surgery on the same elbow will affect his rehabilitation period.

According to Ahmad, Fox News Digital, “A second surgery does not always entail a delayed or slowed rehab process, but there may be some reasons why the rehab process would be a little bit modified and what we would call a little more cautious.” And that is, there’s a great focus on preventing any possible issues if it’s a second surgery. And during the course of treatment, those issues can arise.

“For instance, during the rehabilitation phase, if the athlete experiences any back stiffness. All they’re experiencing is minor back pain. “We can work through that back stiffness” is what you might say if it’s the first operation. In the event that there is a second surgery, however, we might postpone the rehabilitation until the back stiffness subsides. there is because we don’t want the second surgery to have any unfavorable effects on the rehabilitation process. The consequences of a third surgery can be disastrous. Thus, our pace is a little slower.”

There are differences in the recovery times between the two elbow operations. According to Ahmad, who spoke with Fox News Digital, an athlete can start a throwing program in three to four months, while a repair operation could allow them to return to the mound as soon as ten months. Revision reconstructions require a longer recovery period; the throwing program may begin as early as four and a half to five months, and a return to the mound may take up to fourteen months.

Before sustaining a ruptured UCL, Ohtani was expected to seek a record-breaking contract. Now that it’s apparent the 2021 AL MVP won’t pitch until 2025, it’s unclear what effect, if any, the second elbow surgery will have on his free agency.

Coming into the offseason, the Angels have a lot of questions.

The Angels, who finished 73-89 and 17 games out of the last wild card berth in the American League, will not play in the postseason for the eighth straight year.

The team will start looking for their fourth manager in the last six seasons after declining the option on manager Phil Nevin’s contract on Monday.