Keegan Akin Undergoes Tommy John Surgery

The Orioles announced that left-hander Keegan Akin has undergone Tommy John surgery. He will miss the remainder of this year and possibly all of 2027 as well. He’s already on the 60-day injured list and will stay there for the rest of the season. Roch Kubatko of MASNsports.com was among those to pass the news along.

It’s unsurprising-but-brutal news for the lefty. He hit the 15-day IL at the end of June due to elbow discomfort. About a week ago, it was revealed that Akin would be visiting surgeon Dr. Keith Meister for a consultation. A few days later, it became apparent that Akin’s ulnar collateral ligament had been injured and he was moved to the 60-day IL.

Now the worst-case scenario has come to pass. Given that Tommy John surgery usually requires 14 months of rehab or more, he’ll be out of action until late in 2027 and might even miss that entire campaign.

Akin had a pretty strong run for the O’s prior to this season. From 2022 to 2025, he logged 247 1/3 innings out of the Balitmore bullpen, allowing 3.64 earned runs per nine. He struck out 25.4% of batters faced and only gave out walks at a 7.7% clip. He racked up 11 saves and 28 holds in that time.

The results haven’t been as strong this season, as he posted a 5.68 ERA before landing on the injured list. A 59.2% strand rate made that ERA look a bit worse than Akin deserved but this year’s 14.9% strikeout rate was way down from his previous work.

For the Orioles, they were expecting Akin to be their primary relief lefty but instead he gave them lackluster results for the first half and will now miss the second half. Grant Wolfram is the only southpaw in the big league bullpen now. If the O’s decide to buy at the deadline, lefty relief will be a natural target area for them. Their 46-51 record isn’t great but they are only two games back of a playoff spot in this year’s weak American League field.

If they had decided to sell, Akin would have been a natural trade candidate since he’s an impending free agent. His early-season performance already wiped out a lot of his appeal. Whatever lingering chance existed of him salvaging some value is now completely gone.

He’ll head into free agency while still rehabbing and with a long road ahead. Pitchers in that situation sometimes sign two-year deals. That allows them to collect a paycheck while injured, while also allowing them to use team facilities. For the signing team, they get little to no return on investment in the first year but hope that the bet pays off when the player gets healthy for the second year.