Jun. 10—When the Pittsburgh Pirates selected Jose Soriano with the top pick in the Rule 5 Draft in December, they took a risk on a 22-year-old right-hander who still was recovering from Tommy John surgery.
When Soriano dealt with discomfort in his right elbow, team physicians found a significant setback: new damage to his reconstructed ulnar collateral ligament that could require a second surgery for the prospect ranked No. 18 by Baseball America and No. 24 by MLB Pipeline.
Pirates director of sports medicine Todd Tomczyk said the club is in the process of setting up an appointment with Dr. Neal ElAttrache of the Cedars-Sinai Kerlan Jobe Institute in Los Angeles, which performed the initial surgery in February 2020.
"We're still learning more, and we're still learning about all the options," Tomczyk said. "A revision surgery is on the table and is being discussed."
If Soriano requires revision surgery — something former Pirates pitcher Jameson Taillon underwent in 2019 — he would be out for an additional 16-18 months.
"There are about 70% success rates from revision," Tomczyk said, "so if that is the final decision for Jose, the numbers are still in his favor that he could come back."
The Pirates got better news on three other pitchers:
—Right-hander Miguel Yajure (right elbow), acquired from the New York Yankees in the Taillon trade, was found to be experiencing ulnar neuritis after being examined by team physicians in collaboration with famed orthopedic surgeon Dr. James Andrews.
The Pirates' No. 10 prospect by Baseball America and No. 12 by MLB Pipeline, Yajure is in the process of transitioning to rehabilitation in Florida and likely will be out for the rest of June.
"We'll take the opportunity to continue the collaboration with our pitching department, our informatics department, our medical and our strength and conditioning departments alike," Tomczyk said, "to really help Miguel identify all the work he's being doing from the time we acquired him to the time of this mild setback and get him in the best position to compete for the remainder of the season."
—Right-hander Trevor Cahill (left calf) "has responded very nicely" to pitching in simulated games and is showing no signs of discomfort or inflammation, Tomczyk said.
Cahill is on the 10-day injured list, but Pirates general manager Ben Cherington and manager Derek Shelton have said that they are undecided on whether he will return as a starter or reliever.
"He's checked all the boxes from a health perspective and performance perspective," Tomczyk said. "So we're still learning a little bit more from that assessment, from the throwing program and we're just having conversations with Trevor and Derek and Ben to see what the next steps are."
—Left-hander Steven Brault (left lat strain) has progressed to throwing side sessions in Bradenton, where he twice has thrown off the slope.
"He is responding very well to that workload," Tomczyk said. "Steven is making very nice strides."
Kevin Gorman is a Tribune-Review staff writer. You can contact Kevin by email at firstname.lastname@example.org or via Twitter .