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Cleveland Guardians ace Shane Bieber will undergo surgery to repair the ulnar collateral ligament in his pitching elbow, the team announced Saturday. The Guardians did not specify whether Bieber will have Tommy John surgery or the internal brace procedure. Either way, the injury will sideline him the rest of the 2024 season.

Here is the team's statement:

Following his first start in Oakland and subsequent start in Seattle on April 2, Shane Bieber experienced a recurrence of medial right elbow pain. This recurrence of symptoms prompted further medical due diligence, including imaging and evaluation by our team physicians. Imaging and evaluations confirmed the presence of a re-injury to Shane's proximal ulnar collateral ligament. Additional medical opinions from leading sports medicine physicians, Drs. Keith Meister and Neal ElAttrache, confirmed the diagnosis.

Given the recurrence of symptoms following an extended period of rest and rehabilitation during the 2023 season and subsequent off-season, surgical reconstruction of the ulnar collateral ligament has been recommended. We are in the process of coordinating surgery with Dr. Meister in Dallas.  

Bieber was terrific in his two starts this season, striking out 20 and putting only 11 runners on base (10 hits and one walk) in 12 scoreless innings. His most recent start was Tuesday against the Seattle Mariners. Bieber fanned nine in six shutout innings.

Elbow inflammation sidelined Bieber for two months last season and limited him to 21 starts and 128 innings. He recovered in time to make two starts in late September and he looked good throughout spring training, and in his first two regular season starts this year. Clearly though, his elbow is not right, and he needs his ligament repaired.

It is possible, maybe even likely, Bieber has already thrown his final pitch for Cleveland. He will be a free agent after the season and the low payroll Guardians are always unlikely to win a bidding war of that magnitude. High-end starters typically still get paid well on short-term contracts even when they're coming off injury.

Brandon Woodruff, for example, returned to the Milwaukee Brewers on a two-year, $17.5 million contract in February. He will miss 2024 with shoulder surgery. The contract will pay him $2.5 million in 2024 and $15 million in 2025. Woodruff is two years older than Bieber and elbows are generally more fixable than shoulders, so Bieber could command a larger contract.

For the Guardians, the injury is a major blow to a team that is 6-2 in the early going and could contend in a weak AL Central. They are also without righty Gavin Williams, who is sidelined with elbow inflammation, plus top prospect Daniel Espino will miss 2024 following shoulder surgery. Cleveland's pitching depth has thinned considerably.

Also, the Guardians have a history of trading top players even while in contention (Trevor Bauer and Mike Clevinger, most notably). At minimum, they would have been in position to deal Bieber for a large package at the deadline. Now they're faced with losing him for nothing as a free agent. It's an enormous blow to the organization.

Bieber, 29 in May, owns a career 3.22 ERA in 843 innings spanning seven MLB seasons. He won the AL Cy Young award during the shortened 2020 season. Tommy John surgery would shelve Bieber until the middle of 2025. The internal brace could have him back for Opening Day, or soon thereafter.