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Dustin Pedroia undergoes another major surgery on knee

Dustin Pedroia continued to experience pain after his previous surgery; hence the need for another procedure.Jim Davis/Globe Staff file/Globe Staff

At a time when he’d already left the Red Sox to confront questions about his baseball future, Dustin Pedroia underwent another major surgery on his left knee Tuesday.

The team announced that the 35-year-old second baseman underwent a joint preservation procedure performed by Dr. Matt Provencher at the Steadman Clinic in Vail, Colo., and that Pedroia will rehab from the procedure in his home state of Arizona. The surgery, according to a major league source, featured three elements:

■   The use of a plaster-like, bio-inductive substance to strengthen bones and fill hairline fractures beneath the cartilage that formed because of a lack of cushioning in the knee — a relatively new procedure known as a subchondroplasty.

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■   The removal of bone spurs that had grown on the knee in the wake of prior surgeries.

■   A revision of the closure of the wound from a previous surgery, after scarring had restricted Pedroia’s range of motion.

The latest procedure was intended to diminish lingering discomfort from the cartilage restoration surgery that Pedroia underwent in October 2017. Whether it ever permits him to play again remains to be seen; there are no known instances of a player returning to professional sports from subchondroplasty. Pedroia will not play again in 2019.

“It’s something to ease the pain or get the pain away,” said Red Sox manager Alex Cora. “It’s just another step to see where it takes us. He’s going to keep trying to find ways to make this happen. We’ll see where it goes.”

Pedroia, who already had undergone left knee surgery at the conclusion of the 2016 season, suffered catastrophic damage to the cartilage in April 2017 when Manny Machado (then with the Orioles) spiked him during a slide. Though Pedroia managed to play 105 games that year, hitting .293/.369/.392, he did so largely on one leg, and required hours in the trainer’s room every day.

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Pedroia underwent knee cartilage replacement and microfracture surgery after the 2017 season, and after returning for three games in May 2018, went back on the injured list before requiring another procedure last summer.

Though Pedroia opened this season on the injured list, he was activated April 9. Yet after going just 2 for 20 in six games, he landed back on the shelf. When he started a rehab assignment in May, he couldn’t reach a point where he could play for three straight days without significant discomfort.

The fitful nature of his rehab — and the lack of steady progress — led Pedroia in late May to halt his rehab assignment when it became clear that his knee wasn’t responding in a way that would permit him to remain on the field for a sustained period.

“I’m at a point right now where I need some time,” Pedroia said then, acknowledging candidly that he wasn’t sure he’d ever be able to play again.

Pedroia will take stock of his playing future based on how he responds to the surgery and rehab process.

“He’s going to go back home and think how it goes and how it feels,” said Cora. “He’s going to rehab in Arizona and let’s see where it takes us. That’s basically where we [are] at right now.”

Cora said there was potentially one other surgical procedure that Pedroia could consider if this one doesn’t have the desired effect, but suggested that the next option would be “very complicated, so we’ll see where this one goes.”

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Pedroia, the top Red Sox draft pick in 2004 (second round), has played parts of 14 big league seasons with the Sox since his debut in August 2006. In 1,512 games, the four-time All-Star has hit .299/.365/.439 with 140 homers and 138 steals. He is in the sixth season of an eight-year, $110 million extension he signed in the middle of the 2013 season; the deal took effect in 2014 and will run through 2021.

Dustin Pedroia’s injury timeline

2016: Pedroia plays 154 games and hits .318 with an .825 OPS and 12 defensive runs saved.

Oct. 12, 2016: Pedroia has left knee surgery to remove a section of meniscus and smooth arthritic joint surfaces.

April 21, 2017: Pedroia is injured in the eighth inning of a 2-0 loss at Baltimore. On a force play at second base, Manny Machado slides over the bag and spikes Pedroia in the knee. Pedroia misses 56 of the remaining 145 games, twice going on the disabled list.

Oct. 15, 2017: Pedroia has arthroscopic surgery to determine the extent of his injuries.

Oct. 25, 2017: Pedroia has what is termed “cartilage restoration surgery.” He also has microfracture surgery on his tibia.

May 26-29, 2018: Pedroia goes 1 for 11 in three games after coming off the injured list. He returns to the IL May 30 for the remainder of the season.

July 20, 2018: Pedroia has surgery in Arizona to remove scar tissue from his left knee.

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Feb. 15, 2019: Pedroia says the cartilage restoration surgery was a mistake and he would not have undergone it had he known the difficulty in returning.

April 9-15, 2019: Pedroia returns from the injured list and goes 2 for 19 in five games.

April 17, 2019: Pedroia feels a pop in his knee taking a swing at Yankee Stadium in the second inning and leaves the game. He returns to the injured list the next day.

May 2-9, 2019: Pedroia plays in five minor league games.

May 13, 2019: Pedroia’s injury rehabilitation assignment is stopped because of what the Red Sox describe as “minor knee soreness.”

May 17, 2019: Pedroia starts another injury rehabilitation assignment.

May 25, 2019: During a game with Double A Portland, Pedroia takes himself out after two at-bats because of pain in his knee.

May 27, 2019: Pedroia announces he is stepping back and will reassess his situation and whether he can play again.

Aug. 6, 2019. Pedroia has left knee joint preservation surgery.

PETER ABRAHAM


Alex Speier can be reached at alex.speier@globe.com. Follow him on Twitter at @alexspeier.