It's possible Daisuke Matsuzaka has thrown his last pitch as a member of the Red Sox.
After some consultation, Matsuzaka has decided to have season-ending Tommy John surgery on his ailing right elbow and plans to soon tell the Red Sox that, an industry source confirmed late Wednesday night.
Nippon Sports, a Japanese news service, was the first to report Matsuzaka's decision.
Matsuzaka was placed on the disabled list on May 18 with discomfort in his elbow. The Red Sox medical staff determined that he had a sprain -- or slight tear -- in his ulnar collateral ligament and recommended a period of rest and rehabilitation to determine if the elbow could heal without surgery.
He returned to his native Japan last week, then sought a second opinion from noted orthopedist Dr. Lewis Youcum.
Like Red Sox medical director Dr. Tom Gill, Youcum saw a slight tear and told Matsuzaka that one option would be to put off surgery and see if some extended down time along with strengthening the muscles around the elbow could solve the problem. Youcum also acknowledged that Matsuzaka might ultimately require surgery if the prescribed rest and rehab failed to heal the elbow.
The Red Sox would like Matsuzaka to take a more conservative approach and see if he could salvage the season and may still try to convince Matsuzaka to take that path.
If Matsuzaka undergoes Tommy John surgery -- a procedure in which a tendon from another part of the body is transferred to to the elbow, tying the torn ulnar collateral ligament together -- he is certainly finished for the rest of 2011, and possibly, 2012, too, when his landmark six-year deal is done.
Typically, recovery time for Tommy John surgery is anywhere from 12 to 18 months. Matsuzaka's countryman, Junichi Tazawa, underwent the procedure in March of 2010 and only recently graduated from extended spring training and began a rehab assignment in the lower minor leagues.
If Matsuzaka undergoes the surgery later this month, a similar recovery time would place Matsuzaka's return at about mid-August, 2012, just six weeks before he would be eligible for free agency.
Matsuzaka is represented by agent Scott Boras, who also represents outfielder Jacoby Ellsbury. Last year, Ellsbury clashed with the Red Sox medical staff over the diagnosis of his broken ribs which caused him to miss all but 18 games of the 2010 season.
It's possible that the mistrust that stemmed from that conflict informed Matsuzaka's decision, and, at the very least, led him to get a second opinion.
As recently as Wednesday, the Red Sox were publicly hopeful that Matsuzaka could avoid the procedure.
"I think we have to figure out how to best go about this, said Francona Certainly, the player or pitcher has to have some opinion, too, but youre always going to, I think, go about it non-operatively first. That just seems like it makes sense to me.
"Well certainly meet with him in the next couple days. We want to sit down, put our heads together, see how he feels, let Dr. Gill have a talk with Dr. Yocum, and then try to plan out how we go about these next couple weeks.
On Tuesday, Francona had said that there had been no new developments after Matsuzaka saw Yocum.
"Diagnostically, everything is kind of the same,'' said Francona.
The Red Sox, of course, won a spirited bidding war by "posting'' a figure of 51 million in December of 2006, then agreeing to a six-year, 52 million deal with Matsuzaka, a national hero in his native Japan.
Matsuzaka won 33 games over his first two seasons with the Red Sox, but the last two-plus seasons have been marred by injuries and inconsistent performances.