Gagne originally had the procedure in 1997, his second professional season. He said he was starting in a Minor League game 11 months later, and predicted he would return by next May.
In addition, backup catcher Paul Bako also has a Friday surgical date to reconstruct his left knee, likely with a cadaver anterior cruciate ligament. Minor League journeyman Mike Rose will continue as Bako's replacement.
There is, of course, no true replacement for Gagne, signed to a two-year, $19 million contract over the winter, because he was the best closer in baseball the previous three years and one of the best in history.
But he sprained his left knee in Spring Training, rushed back to be ready for Opening Day and tried to pitch through the pain of the knee, only to sprain his surgically repaired elbow.
Supposedly healthy from the spring sprain that sidelined him the first six weeks of the season, Gagne returned May 14, but his 97-mph fastball never did. He made 14 appearances this year and went 8-for-8 in save opportunities mostly on guile, then acknowledged re-injuring the elbow June 12. An MRI revealed a partially torn transplanted ligament.
Rookie Yhency Brazoban, who has saved 11 of 14 opportunities in Gagne's absence this year, has resumed closing, while general manager Paul DePodesta indicated the club will explore internal solutions to bolster the bullpen before looking outside the organization through trades.
One of the more intriguing options could be 21-year-old Jonathan Broxton, a second-round pick out of high school in the 2002 Draft who has been shifted to the bullpen in Double-A Jacksonville. Broxton has only 270 professional innings, but DePodesta promoted Brazoban to the Major Leagues last year with only 128 professional innings.
"We won't jump and do anything the next couple weeks," said DePodesta. "We'll see if our internal options come through. I'm not that concerned about Brazoban. But can we replace him in the eighth inning? Duaner Sanchez has come a long way in the past year. We have to have some other options. We have some guys in-house. We have four weeks to determine how they may fit and, if they don't, then we can look outside."
Gagne, 29, said having had the operation previously puts him in a better mental and physical position to have it again.
"I'm a lot more confident because I know what I've got to go through," he said. "It's just a matter of time. I know I'll come back 100 percent, maybe stronger when you rehab that hard. I'm anxious to come back."
But the waiting and watching will be the hardest part. Viewed by teammates and management as a team leader, Gagne said he will spend as much time around the club as possible while rehabilitating.
"Watching the games on TV is frustrating," he said. "I want to be there for the young guys and to be part of it and for myself, too. I need it or I'll go crazy sitting here watching baseball."
Gagne would be the second established Dodgers Major Leaguer to require two Tommy John operations, named after the former Dodgers left-hander who served as guinea pig for Dr. Frank Jobe's 1974 revolutionary procedure that has extended the career of hundreds of pitchers.
The other is Darren Dreifort, and that is a truly sad story, because Dreifort suffers from a degenerative condition in which his connective tissues steadily break down. Although he returned to pitch following his second elbow operation, the rest of Dreifort's body broke down and he will spend the entire 2005 season on the disabled list following four offseason operations.
There has been no indication that Gagne suffers from anything similar. Manager Jim Tracy said he was told Gagne's career is not in jeopardy and DePodesta concurred.
"They said there's a high rate of success," DePodesta said. "This one is not complicated, it's pretty straightforward. Hopefully, it's the second and last for him."
Nonetheless, it is unusual for a Tommy John procedure not to work, even after the seven-plus years Gagne has put his elbow through. Gagne had his original surgery in 1997 after his first season of professional ball. The Dodgers have an option/buyout on Gagne for 2007.
Jobe's procedure requires transplanting a tendon (usually from the opposite forearm or calf) to replace the torn ulnar collateral ligament that holds the bones of the lower arm (the ulna and radius) and those of the upper arm (the humerus) together at the elbow.
Typically, eight months is required before resuming throwing. Occasionally, a non-pitcher can return in as little as nine months. It took John 18 months. Jobe has since refined the procedure, no longer relocating the ulnar nerve, and the average prognosis is a 12-month recovery.