A rare trifecta set for Parker?

GOODYEAR, Ariz. — In reality, the soaring number of Tommy John surgeries the past two years has been much more about the increasing incidences of second ulnar collateral ligament repairs, or revisions. And the A’s have been right in the middle of that conversation with Jarrod Parker, the team’s onetime ace who is likely to undergo his third such procedure April 1 in Los Angeles.

The A’s have not announced what kind of surgery Parker will have, but given his injury history — a second Tommy John surgery two years ago, two fractured elbows since — Dr. Neal El-Attrache is expected to have to replace the ligament if there is enough bone remaining to anchor it.

The only pitcher known to have returned to the big leagues after a third Tommy John surgery is Jonny Venters, but there are no records of any pitcher coming back from an avulsion fracture of the medial epicondyle — Parker’s injury — at the majorleague level.

According to Yahoo baseball columnist Jeff Passan in his new book, “The Arm: Inside the Billion- Dollar Mystery of the Most Valuable Commodity in Sports,” avulsion fractures of the medial epicondyle are most frequently seen in youth baseball players.

“It’s such a rare injury in adults,” Passan said by phone Friday.

The unusual nature of the injury, and the fact that it first occurred less than 14 months after Parker’s second Tommy John surgery, calls into question how quickly everyone involved — the team, surgeon Dr. James Andrews and Parker himself — tried to get him back to work as a starter, especially since most pitchers who successfully return from revisions come back as relievers.

Many experts believe second Tommy John surgeries require 18 to 24 months of recovery, compared with the usual 12 to 18 months for first- time procedures. Parker had surgery on March 24, 2014, and the first fracture happened during a rehab start on May 8, 2015.

“So many guys, up until the last two or three years, had tried an accelerated recovery time,” Passan said. “Tim Hudson was back on the mound in 11 months ( after a first Tommy John surgery) and there was a shift in thinking. But for every Tim Hudson, there are a dozen who fail, and now we’re seeing more 15- month recoveries for the first time. Frankly, there shouldn’t be a rush. Everyone in baseball should understand that time is your friend — but you might give a player 15 months and he might still get hurt again.”

It always was considered a long shot that Parker, 27, would make it back to the big leagues; he incurred the repeat fracture on March 10 when facing hitters for the first time since his May injury. Now he faces even longer odds.

“I don’t ever count anyone out,” Passan said. “But with two Tommy Johns and two epicondyle fractures, it’s going to be really, really tough. The arm can take only so much.”

Manager Bob Melvin has spoken to Parker. “He’s tough," Melvin said. “He’s trying to keep it pretty narrow in how far out he’s looking.”