49ers’ Brock Purdy postpones elbow surgery on eve of operation

Brock Purdy’s throwing elbow remains inflamed, so surgery on the 49ers’ quarterback has been postponed from Wednesday until likely next month, a league source confirmed Tuesday night.

Dr. Keith Meister recommended pushing back the procedure after examining Purdy in the Dallas area. That came on the eve of what still is expected to be a procedure in which an internal brace is inserted to repair a torn ulnar collateral ligament, as Tom Pelissero of NFL Media first reported.

The Press Democrat’s Inside the 49ers blog

Purdy tore the UCL in his right elbow when he was hit on the 49ers’ opening possession of their NFC championship game loss at Philadelphia on Jan. 29.

The delay to repair it wasn’t a surprise, in case the torn ligament needed to “cool down,” as Purdy told KNBR 680-AM on Feb. 9.

“They want to make sure when they go in that they know what they’re looking at, that the ligament has started to heal on its own and it just allows the process to go smoothly,” Purdy added, “whereas if you tear it right away and go in and have surgery, the ligament is all up in pieces, there’s a lot of inflammation and fluid in there.

“So allowing it to actually cool down for a couple of weeks and then go in and have surgery, that’s what a lot of surgeons said is the best option, so that’s how we’re rolling with it.”

Purdy will revisit Dr. Meister next month, and the plan remains to go forward with an internal-brace repair that could have Purdy throwing within three months of surgery and practicing within six months. That timeline would push him close to the 49ers’ season opener in early September.

Trey Lance, the 49ers’ top draft pick in 2021, is expected to serve as the 49ers’ top quarterback when they reconvene April 17 for the offseason program, with organized team activities starting in mid-May. That assumes Lance’s right ankle is medically cleared, having required a follow-up procedure Dec. 30 to remove a stabilizing screw.

Jimmy Garoppolo will become a free agent next month and is expected to sign elsewhere, as early as March 17 when the league year begins. Coach Kyle Shanahan said last month he could not envision a scenario in which Garoppolo returns, having had last season cut short by a Dec. 4 foot fracture that did not heal in time for him to be available in the playoffs or even practice.

While Purdy’s best-case scenario is to come back in time for the start of the season, that would entail him avoiding a more serious surgery, from a complete reconstruction (Tommy John surgery) to a hybrid procedure.

“There’s a backup plan, of having a hybrid surgery, which means a little bit of the graft and then an internal brace, which could be anywhere from seven to nine months,” Purdy told NFL Network prior to the Super Bowl. “But the plan right now and what all the surgeons have said is an internal brace for a six-month recovery.”

Kenta Maeda, a Minnesota Twins pitcher, underwent that hybrid surgery with Dr. Meister in September 2021, 11 days after he tore his UCL. Maeda was able to throw bullpen sessions the following summer but did not pitch last season, and he’s since resumed throwing at the Twins’ spring training this month.

Last April, Dr. Meister performed UCL reconstruction on Oakland A’s pitcher Deolis Guerra, using a palmaris longus tendon graft. Guerra is at  A’s camp but not throwing yet, because of a lat strain.