A surgery — and allergy — cost him 2025 season. Now, he’s back with the Royals
AI-generated summary reviewed by our newsroom.
- McArthur had screws placed in Nov. 2024 and developed a metal reaction.
- One screw removed early; other taken out in July 2025 after reaction found.
- He resumed throwing late 2025 and enters camp ready to rebuild his arm.
James McArthur took a seat at his locker in the Kansas City Royals clubhouse Tuesday morning.
After a few minutes, McArthur started to put on his gear ahead of some light throwing at the spring training facility in Surprise, Arizona. He grabbed his glove and a baseball before heading out to the field.
It had been a while.
“The main goal for me is to just get back on track to becoming the best pitcher I can be,” McArthur said. “And I think that’s got to be my main focus going forward. I’ve got to get back to the pitcher I was before all this stuff.”
Two years ago, McArthur was a major part of the Royals bullpen. He notched 18 saves in 57 games as the Royals reached the postseason in 2024. However, McArthur sustained an elbow strain in late September of that season.
The initial diagnosis was a grade 1 ulnar collateral ligament (UCL) sprain. The following offseason, McArthur underwent surgery to place two screws to stabilize his elbow.
McArthur figured it would be the standard recovery timeline. Yet, what he encountered was something more serious than expected.
“They put screws in my elbow in November of 2024 to fix a stress fracture,” McArthur said. “I was allergic to the metal. So the whole time we were trying to build up, I was fighting a reaction in my elbow and things just never felt good.”
McArthur missed the entirety of Royals spring training — and ultimately the season — in 2025. The medical staff worked to understand what led to his continued discomfort. At first, McArthur had one of his screws removed due to the belief it was in a bad spot.
“I was super puffy,” McArthur said. “I don’t want to get too deep into it, but it’s just like when they saw the image, they could see stuff in my elbow and they were like, ‘This isn’t normal.’ And their only thought or best guess through imaging was that it was like bone chipping from the screw head that was sticking out of the bone just a touch.”
The medical team would find out that it wasn’t loose bone fragments in his elbow. Instead, it was deep tissue that was undergoing a reaction to the metal. So, McArthur had the other screw removed last July.
“These guys are professionals and they have seen thousands of cases,” McArthur said. “So, it’s a very rare thing and that’s why it was so unfortunate and just so odd that we weren’t bouncing back. But we got it figured out and I’m on the right track now.”
McArthur was able to start throwing again at the end of the 2025 season. He underwent a healthy offseason program and looks to build up his arm over the next few weeks.
The Royals will bring him along slowly. McArthur has thrown off the mound for a few months and is hopeful he can face hitters soon.
“For him as a person and competitor, I’m extremely excited (to have him back),” Royals manager Matt Quatraro said. “You guys know, he is the consummate teammate and did everything he could possibly do for us in a capacity that was really challenging for him and his family. Just the continual setbacks and what that does to you mentally. For him as a person and what he has done for us on the field in previous years, I can’t wait to see him get back out there.”
The Royals bolstered their bullpen this offseason with the additions of Alex Lange, Matt Strahm and Nick Mears. The trio brings more veteran experience alongside returnees Carlos Estévez, Lucas Erceg and John Schreiber.
McArthur is excited to learn from the group. He studied the game while sidelined and is ready to produce when his number is called.
“It’s mainly a bunch of small things, but just kind of a different perspective helps,” McArthur said.
Meanwhile, McArthur hasn’t pitched in a regular-season game since Sept. 16, 2024. His recovery process included a lot of setbacks, but he’s finally overcome them.
Now, he looks to channel it all toward a return to game action.
“Overall, it was a tough year and a lot of adversity,” McArthur said. “That’s kind of what this game’s about. So to me, it’s how can you bounce back the next day? How can you bounce back the next season? And I’m feeling good now. Headed into camp ready to get back out there and pitch.”
This story was originally published February 11, 2026 at 5:30 AM with the headline "A surgery — and allergy — cost him 2025 season. Now, he’s back with the Royals."