SARASOTA, Fla. -- New York Mets left-hander Johan Santana will proceed with surgery to repair a torn anterior capsule in his left shoulder for a second time in 31 months, ending his 2013 season before it began.
Team doctor David Altchek, who performed Santana's first anterior capsule surgery on Sept. 2, 2010, will again perform the surgery. Santana took 19 months to throw a major league pitch after the first shoulder surgery.
The Mets are responsible for $31 million owed to Santana this season, including a 2014 buyout.
"I've known Johan long enough to know that I don't think that he would want to go out like that," Mets captain David Wright said. "So he's going to probably work just as hard, or if it's possible work harder, to come back from this. I wouldn't be surprised if I see him pitch again."
Wright briefly spoke with Santana on Thursday, after the results of an MRI showed a tear but before Santana had committed to the surgery.
"He was kind of in a bit of shock," Wright said. "I don't think anybody was expecting this. He said he did everything possible to rehab this thing. He did everything the right way. For this to happen, I think for everybody, including him, it's kind of shocking and disheartening.
The surgery to repair a torn anterior capsule had been performed previously on only a handful of pitchers, beginning with Bret Saberhagen on May 28, 1996, Altchek told ESPNNewYork.com last year. The surgery on Santana left a two-inch scar at the front of his prized shoulder.
Because anterior capsule surgery has been performed so infrequently on pitchers, how Santana's recovery unfolds will contribute to determining the procedure's effectiveness in extending careers, Altchek had added.
The capsule is the set of ligaments that run between the ball and socket, holding them in place. The ligaments nearly completely encircle the shoulder. They span the front, bottom and back of the shoulder, but not the top.
Tearing the anterior capsule can result in the ball slipping forward in the shoulder socket during the delivery. Young actually felt discomfort in the back of his right shoulder before his May 16, 2011, surgery -- even though the tear was in the front of the capsule -- because the rear ligaments that remained intact were stretching as the ball slipped forward in his socket.
If the tear occurs on the socket side, the repair can be done through a less invasive arthroscopic procedure, as was the case with Braden, as well as former New York Yankees catcher Jorge Posada. If the tear is on the ball side, the surgeon is required to make an incision and go in through the front. That was the case with both Santana and Young.
Torn anterior capsules very likely are not new injuries among pitchers. Standard MRIs often are not conducive to revealing the tears. A more sophisticated MRI usually is required, or some other sleuth work.