CHICAGO -- Hunter Greene underwent Tommy John surgery to repair the damaged ulnar collateral ligament in his right elbow on Wednesday, the second time the Reds’ ace has required the procedure.
Manager Terry Francona confirmed Thursday that Greene underwent a Tommy John revision rather than the less extensive internal brace procedure that had also been considered. His recovery timeline is expected to be 12-18 months, ending his 2026 season and likely sidelining him for all of 2027.
The Reds announced last Friday that Greene would need surgery, but the exact procedure could not be determined until doctors operated.
When asked how difficult it was to learn the extent of Greene’s surgery, Francona acknowledged the significance of the news but said the Reds must continue adjusting as they navigate the remainder of their season.
“Whatever it is, you adjust,” Francona said.
It marks another substantial setback for Greene, who missed the beginning of this season after undergoing arthroscopic surgery on March 11 to remove bone chips and loose bodies from the same elbow.
The 27-year-old reported soreness during a side bullpen session Aug. 4. He visited team orthopedic surgeon Dr. Tim Kremchek and underwent an MRI the following day before traveling to Los Angeles for a second opinion from Dr. Neal ElAttrache on Aug. 6.
Greene had experienced intermittent soreness for multiple weeks but initially believed it was part of his recovery from the March procedure.
“He said he was sore off and on for a couple of weeks,” Reds president of baseball operations Nick Krall said Friday. “At the same time, it wasn’t something he brought to anyone’s attention because he thought it was just, ‘Hey, you’re coming off the bone chip surgery. You’re just going to push through it.’”
Both doctors determined that Greene’s UCL required repair, though the full severity of the damage and the appropriate surgical route would not be known until the operation began.
“Both said when you go in there, you’re going to find out what it is and then go from there,” Krall said.
Greene previously underwent Tommy John surgery in 2019 while pitching in the Minor Leagues. Since making his Major League debut in 2022, the second overall selection in the 2017 Draft has spent time on the injured list in each of his five seasons.
His healthiest and most productive season came in 2024, when he earned his first All-Star selection and established career highs with 26 starts, 150 1/3 innings and 169 strikeouts. He followed that by posting a 2.76 ERA with 132 strikeouts across 107 2/3 innings in 2025, though two IL stints caused by a right groin strain limited him to 19 starts.
Greene made only five starts this season after returning from his March elbow surgery. He went 2-2 with a 6.83 ERA, recording 33 strikeouts across 27 2/3 innings.
His prolonged absence removes a cornerstone from Cincinnati’s rotation well beyond the current postseason chase. The Reds had hoped to build around Greene and emerging right-hander Chase Burns atop their rotation, but Greene’s recovery timetable places the possibility of an extended run together on hold.
For now, Cincinnati will move forward with a rotation that includes Burns, Andrew Abbott, Brady Singer, Nick Lodolo and Rhett Lowder while Greene begins another lengthy rehabilitation process.