BOSTON (AP) — Red Sox starter Chris Sale had Tommy John surgery on his left elbow on Monday, his 31st birthday, and the team said it was successful.

The procedure was performed by Dr. Neal ElAttrache at the Kerlan-Jobe Institute in Los Angeles.

Sale is expected to miss 14-15 months, which would bring him back in the middle of the 2021 season.

Sale missed the start of spring training with an illness that the team described as a flu that morphed into pneumonia. The Red Sox then said he had a flexor strain near the elbow, but the team hoped he would avoid ligament replacement surgery.

A seven-time All-Star, Sale is 109-73 in 10 major league seasons and entering the second season of a six-year, $160 million contract. After helping the Red Sox win the 2018 World Series, he went 6-11 with a 4.40 ERA in 25 starts last year — his fewest wins and starts, highest ERA, and the first time he failed to finish in the top six in Cy Young voting in any full season as a starter.

“Tommy John’s been a factor in my life for 20 years now,” Sale said earlier this month. “It’s on the table, but it’s always been on the table. So, that’s not something I’m going to worry myself with. I can’t go out there with that in the back of my mind. I have to have the confidence that what we’re doing is going to work.”

(Copyright (c) 2024 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

Join our Newsletter for the latest news right to your inbox