Long-term future of Royals' rotation could dramatically change after latest Cole Ragans update

The Kansas City Royals have looked rejuvenated of late, winning for of their last five games and outscoring their opponents 44-27 in that span. However, one thing that has remained constant through all their ups and downs this season has been their immense injury woes that always seem to find a way to get worse. After placing one of their cornerstone pieces in Maikel Garcia on the injured list on Tuesday, it didn't take long for the Royals to receive even worse news, this time regarding their ace, Cole Ragans.

As first reported by Jaylon Thompson of the Kansas City Star, manager Matt Quatraro said that Ragans will likely require surgery for his elbow impingement that's kept him out since early May.

"We don't know, as of right now, what it means," Quatraro told Thompson. "He's got to see another doctor as well, but we anticipate it being surgical."

This news shouldn't come as a complete shock to the Royals faithful given the fact he had to be recalled from his rehab assignment earlier this season plus all of the ominous updates on his elbow since then. And given the fact that he spent most of the season on the IL in 2025, Royals fans unfortunately have become all too familiar with their ace being on the shelf.

However, this time around, the injury news is more serious as it's ever been. If he does in fact require surgery following his next meeting with doctors, not only will it be the first time he's required surgery as a member of the Royals, but it will mark his third elbow surgery of his professional career. Back when he was a Rangers prospect, Ragans underwent Tommy John surgery in 2018 and then again shortly after in 2019.

How will the Royals rotation look moving forward if Ragans goes under the knife?

Now, there's still ambiguity on what type of surgery would be required for his elbow impingement. Many may see the words elbow and surgery and quickly assume Tommy John, however, as Brian Murphy of MLB.com reported, Quatraro did not specify on what the procedure would be or whether or not this would end Ragans' season.

That being said, the more elbow surgeries a pitcher has, the less confident you feel that they'll be able to return to peak form. And for Ragans that peak form was a strikeout machine and Cy Young-caliber arm who seemed a lock to be the Royals' Opening Day starter for years to come.

Obviously, nobody has a crystal ball and can predict the future, so perhaps it's not time to completely write off Ragans. However, again, it's not unreasonable to think that Ragans' prime days might be behind him with so much work done on his elbow and given the fact this could be essentially be two seasons in a row lost to injury.

If that's the case and the Royals suddenly are down an ace, how will they replace him? While Michael Wacha and Seth Lugo have been strong names in 2026 in order to keep this team afloat, both have been floated in trade rumors this summer and both are also firmly in the latter stages of their career in their mid-to-late 30s. Then, there's Kris Bubic who's undergoing injury issues of his own and is set to hit free agency next season.

This leaves the likes of Noah Cameron, who's rebounded well from his slow start, but doesn't exactly scream of an ace of the future. And the likes of Stephen Kolek, Luinder Avila and Ryan Bergert (who's also injured) have proven to be good complementary rotation pieces, but need to show a lot more before the Royals can bet on them with their future.

Perhaps that means they'll have to wait and hope the likes of top prospects Kendry Chourio, David Shields and Justin Lamkin can continue to ascend through the minors and live up to expectations when they finally get the call to the majors, but that will certainly take some time.

It appears the Royals have a clear mission this winter if they hope to compete in 2027 and that's to bolster up their rotation, because if Ragans has taught us anything, it's who knows what the future holds.

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