Miller underwent surgery to replace two pulley ligaments in the finger with a tendon from his wrist. It's an innovative medical move -- right up there with the elbow ligament replacement surgery Tommy John had performed in 1974. John had his career prolonged by the surgery that now bears his name, and the once-revolutionary procedure has become quite common. Only time will tell if Miller enjoys a similar fate.
For now, all the Indians can confirm is that the 24-year-old Miller had the surgery performed by team hand specialist Dr. Tom Graham at the Curtis Hand Center in Baltimore. An update on how the surgery went was not immediately available.
"I feel bad for the kid," manager Eric Wedge said. "Adam's a good kid and he's worked hard. He's had so many setbacks. Hopefully this will be the last one and he's able to come back."
The Indians can't offer up much of a guess as to how likely Miller is to recover from this surgery and revive his career, because it's such a rare and complicated case.
Miller's finger troubles date back to May 2007, when he strained a ligament and missed more than a month at Triple-A Buffalo. In Spring Training last year, he didn't appear in any of the Tribe's exhibition games because of a blister that formed on the finger. The blister was a result of the ligament causing his skin to sag against the ball. Miller pitched with the open hole on his finger through six starts at Buffalo before he was shut down and had season-ending surgery in May to seal the hole.
This past spring, Miller was expected to be the favorite for the open spot in the Indians' bullpen. He was converted to relief work because of the time he missed last season and the need to limit and monitor his workload.
But Miller never made an appearance in an exhibition contest. First, he battled a bout of finger soreness. Then he realized he couldn't bend the tip of the finger, drastically affecting his delivery. For several weeks, the Indians worked with Miller on altering his release point from the middle finger to the pointer finger, and he appeared to be making dramatic strides in the adjustment. But when the soreness returned earlier this month, it became apparent that surgery would be necessary.
The career-threatening surgery, as explained by head athletic trainer Lonnie Soloff, comes with no guarantees that Miller will regain the lost range of motion in the finger. And it also comes with the threat of scar tissue.
"Because the space is so limited, with a procedure of this caliber, there is a high incidence of secondary surgery to limit or remove scar tissue which would impede recovery of both range of motion and strength," Soloff said last week. "There's no way of knowing when that would take place. It's just a complicating factor of the injury, of the surgery and of the subsequent rehab."
The odds, then, are against Miller, whose dazzling upper 90s fastball once made him seem a sure thing. The Indians took Miller with the 31st overall pick in the 2003 First-Year Player Draft, and his ascension to the big leagues was supposed to be a quick one. His professional career, however, has been derailed by medical issues, including a right elbow injury that limited him to 15 appearances at the Class A level in 2005.
"He has a great deal of ability," Wedge said. "I feel bad for him just personally, because he's been through so much in such a short period of time."
Anthony Castrovince is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.