Middleton received a recommendation to undergo Tommy John surgery on the UCL in his right (throwing) elbow.

Middleton appears set to miss the rest of the 2018 season and at least half of 2019 after undergoing the reconstruction. The organization discussed stem-cell and platelet-rich-plasma therapies as alternatives, but a full repair was deemed to be the necessary course of action, according to Fabian Ardaya of The Athletic Los Angeles. In the meantime, the Angels will deploy Blake Parker, Jim Johnson, Justin Anderson and possibly Cam Bedrosian in save opportunities, though the resurgent Parker is the best season-long guess for this bullpen.

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