OAKLAND -- It's a disheartening thing for any player to deal with Tommy John surgery. Imagine, then, having to undergo the procedure twice -- the second time just three years later, no less.
Joey Devine is living this nightmare.
It was revealed on Tuesday that the A's reliever was forced to undergo his second Tommy John surgery in Pensacola, Fla., and will miss all of the 2012 season. His first operation was performed April 21, 2009, and Devine proceeded to not only miss that year but 2010, as well. Since then, he's made just 26 big league appearances.
"In instances like this, you don't even consider what it means to the club," manager Bob Melvin said. "It's all about him, right now. The frustration level and the sadness he's going through ... having worked his way as diligently as he did to come back, it's tough. To have to go back and do that again, I really feel bad for him."
Though uncommon, a second Tommy John surgery is not foreign to the baseball community. In fact, it's becoming more frequent, though Devine's case remains slightly rarer -- in light of the short timeframe between the two surgeries.
The Royals, in Oakland for a three-game set that concludes on Wednesday, watched their own Joakim Soria undergo a second Tommy John surgery just last week. The Royals closer first had it done in 2003 as a Minor Leaguer.
Elsewhere, left-hander Chris Capuano, currently with the Dodgers, had Tommy John surgery in 2002 and again in 2008. He made his return in 2010 with the Brewers and last year, pitched with the Mets, posting an 11-12 record and 4.55 ERA in 31 starts (33 appearances overall).
Other pitchers to endure the procedure more than once include: Hong-Chih Kuo, Doug Brocail, Scott Williamson, Al Reyes, Darren Dreifort, Shawn Kelley and Mike Lincoln. Jason Isringhausen has gone through the surgery three times, while Jose Rijo had five Tommy John procedures before his career ended.
According to A's head trainer Nick Paparesta, youth is on the 28-year-old Devine's side. The righty had been plagued by discomfort in the flexor-tendon area for more than two years, particularly after three appearances this spring. Ultimately, Dr. James Andrews -- who also performed Devine's first surgery -- ended up taking the arthroscopic route on Tuesday.
What Andrews found was significant damage. Not only was there a tear in Devine's ulnar collateral ligament, but he had to monitor the debridement of the flexor tendon and also repair damage to the ulnar nerve, which was covered in scar tissue.
"They've obviously grown close over the last few years," Paparesta said of Devine and Andrews. "When I spoke to Dr. Andrews to see how everything went, he was just as upset as Devine. ... He gave it all he had."
Dr. Frank Jobe, the originator of the Tommy John surgery in 1974, recently spoke to MLB.com and admitted that, with a second round of the procedure, "you do worry a little bit more."
"There's a couple reasons for that," Jobe said. "One, you might be someone whose connective tissue is not quite as quality as the other guys who have gotten it just once and it held up. The other thing is, he might have gone back to pitching too soon. You can't be sure, though. If you're going to do it a second time, you want to be sure that you're going to get some really good tissue to replace it this time around."