NEW YORK — First it was John Means. Then it was Tyler Wells. Now it’s Kyle Bradish and Danny Coulombe.

Orioles executive vice president and general manager Mike Elias on Wednesday announced that Bradish, one of the best starting pitchers in the American League, and Coulombe, one of MLB’s best left-handed relievers, both underwent elbow surgery this week.

Bradish underwent Tommy John elbow reconstruction surgery Wednesday and will miss the remainder of the season and at least the beginning of 2025. Coulombe had surgery to remove bone chips from his elbow Tuesday, and Elias said the Orioles are hopeful he can return this season, potentially in September.

“Kyle [is an] enormous talent, enormous part of the team. This is a huge blow,” Elias said. “This guy is really a tough hombre. He pitched through an injury. We were marveling at how well he was pitching with it. He gave us everything he had. We’re going to miss him. We’re going to take really good care of him and get him back to full strength with everything in our power.”

Bradish, who injured the ulnar collateral ligament in his elbow during his start Friday against the Philadelphia Phillies, joins Means and Wells as Orioles starting pitchers to undergo UCL surgery in the past 17 days. Means underwent Tommy John surgery for the second time of his career June 3, while Wells had his UCL repaired Monday, opting for the new internal brace procedure that could lead to a quicker recovery.

“A huge loss for us,” manager Brandon Hyde said. “We feel confident he’s going to be like that when he comes back, but it’s going to be a while. We’re losing a top-of-the-rotation arm that’s been unbelievable for us for the past year-plus. We were hopeful it wasn’t going to come to this, but unfortunately it has and we’re going to miss him.”

Bradish had his surgery — UCL reconstruction with internal brace augmentation — Monday with Dr. Keith Meister in Texas, Elias said. Meister, who also performed Means and Wells’ surgeries, has developed a hybrid procedure during which a pitcher receives Tommy John surgery and then has an internal brace added on to provide more support. However, Bradish’s recovery won’t differ from the typical 14-to-16 month timeline, which could have him return in the second half next year.

“It’s more likely to be a timeline that we’re familiar with rather than the one that’s a little bit shorter that we’re hoping for with Tyler,” Elias said.

The 27-year-old Bradish finished fourth in AL Cy Young Award voting last year when he broke out to become the Orioles’ ace. He missed the first five weeks of the 2024 season with a sprained UCL — technically a partial tear — he suffered in the offseason and treated with platelet-rich plasma injections to speed his recovery. That injury raised concerns about Bradish’s future, as pitchers who sprain their UCL often need surgery.

Elias said it wasn’t a legitimate consideration for Bradish to undergo Tommy John surgery in the offseason, but it was after the right-hander’s elbow worsened Friday when he pitched through pain.

“Of course, if you have UCL damage, it’s hard to have a conversation about that without that question coming up,” Elias said. “But there was at no time in that timeframe was anyone seriously considering it based on the way he responded [to the PRP injections] and just the particulars of the case and what Kyle said and what he wanted to do.”

Elias and Hyde praised Bradish several times for his toughness this season. Pitching through a sprained UCL, Elias said, is difficult mentally and physically, and he was impressed that Bradish, whom the organization acquired in the Dylan Bundy trade in 2019, looked as dominant as he did. Bradish posted a 2.75 ERA in eight starts, including seven no-hit innings in Chicago and retiring 18 of 19 batters against Tampa Bay.

“It’s not easy to do,” Elias said. “You have to build your arm back up a certain way, and we did all that because this guy wanted to pitch and he wanted to win baseball games for this team. He did that as long as he could. He’s a tough guy, and he’s a great player.”

“Kyle Bradish is an absolute warrior,” Hyde said. “I think he probably didn’t let on what he was pitching through, honestly, because he loves to compete, he wants the ball, he does not want to come out of the game. He’s just a fierce, fierce competitor.

“He’s as tough as any player that I’ve had.”

Baltimore’s rotation has held up despite the rash of injuries, as journeyman Albert Suárez, southpaw Cole Irvin and now rookie Cade Povich have stepped up to fill key innings while Corbin Burnes and Grayson Rodriguez have led the way. But the absence of Bradish for the remainder of the season is a sizable blow, and it could motivate Elias to dip into the starting pitching market at the trade deadline.

“It’s so complicated,” Elias said when asked about the deadline. “It’s just kind of hard for me to make sweeping statements and opine about it, especially in June. But we have, what I think, is a really good, hard-working front office, and we’re going to do our job.”

In 2023, only seven Orioles pitchers spent time on the injured list as the club ended the season with the fifth-fewest IL days in MLB. Less than halfway into the 2024 campaign, they’ve already reached the same number: Cionel Pérez, Rodriguez, Dean Kremer, Coulombe, Bradish, Wells and Means. Despite the injury woes, the Orioles sport a 3.09 ERA that ranks second in the majors.

Elias said the Orioles are “very hopeful” Coulombe will return to Baltimore’s bullpen this year. The left-handed reliever had his surgery with Dr. Neal ElAttrache in Los Angeles. The typical recovery for bone chip removal surgery is a few months.

Since the Orioles acquired him in an under-the-radar cash trade last March, Coulombe has been one of Hyde’s most-trusted relievers. For at least the foreseeable future, Hyde will need to use other pitchers to fill Coulombe’s shoes.

After a breakout 2023 campaign in which the journeyman posted a 2.81 ERA and impressive peripherals with his sixth MLB organization, Coulombe was even better to begin 2024. In 26 innings, Coulombe recorded a 2.42 ERA with a staggering 0.615 WHIP and 9.33 strikeout-to-walk ratio. Those All-Star-caliber numbers don’t just make him one of the most effective left-handed relievers in the AL, but one of the best bullpen arms in the major leagues. He leads all qualified relievers in WHIP and ranks top 10 in batting average against (.146) and walk rate (3.3%).

Coulombe appeared in 29 games before his injury, although that doesn’t include the times he’s warmed up in the bullpen without entering to pitch. He went a season-high two innings June 8 and threw 30 pitches in a win over the Rays and said he felt unfamiliar soreness the next day.

With the Orioles consistently playing competitive games with high-leverage moments in the late innings, that puts more stress on a bullpen that entered the year without closer Félix Bautista (Tommy John surgery).

The Orioles recalled relievers Bryan Baker and Nick Vespi to replace Coulombe and Bradish on the roster. Baker and Vespi have both had some success in Baltimore in recent years, especially in a small sample this year. But there’s no replacement for Coulombe, a left-hander whose mostly breaking ball arsenal makes him nearly as good against right-handed batters as lefties. Hyde often used Coulombe in some of the highest-leverage moments of a game, and the southpaw rewarded his skipper by stranding all 13 runners he inherited this season.

“We feel good that he’s probably going to be back with us for sometime in the last part of the season, but he’s been a huge piece of our bullpen,” Hyde said. “We’re going to miss him for the time he’s gone.”

Around the horn

Elias said Kremer will make a second minor league rehabilitation start for Triple-A Norfolk on Saturday. Kremer, who was placed on the 15-day IL a month ago with a triceps strain, is expected to throw around five innings and 75 pitches. Elias said the organization will decide next steps after Kremer’s start. It’s possible Baltimore goes back to a six-man rotation when Kremer returns, or space could be created by moving Suárez to the bullpen or optioning Povich back to the minors.

The Orioles selected the contract of utilityman Nick Maton from Triple-A on Wednesday after third baseman Jordan Westburg exited Tuesday’s game with a hip injury. Westburg was out of Wednesday night’s lineup but is “trending better,” Hyde said. Outfielder Kyle Stowers, whose playing time has diminished in recent weeks, was optioned to Norfolk, while Wells was transferred to the 60-day injured list to make room for Maton on the 40-man roster.