Kansas City takes fourth hit to staff

— Felipe Paulino tore a ligament in his right elbow and likely will become the fourth Royals pitcher to have elbow ligament replacement surgery this season, tempering the positive news that catcher Salvador Perez is finally coming off the disabled list.

The Royals announced in a statement Friday that team doctors diagnosed Paulino with a torn ulnar collateral ligament, which usually requires season-ending reconstructive surgery. The right-hander will get a second opinion from Los Angeles Angels medical director Dr. Lewis Yocum.

Kansas City already has lost starter Danny Duffy, reliever Blake Wood and closer Joakim Soria to elbow ligament replacement surgery. Yocum performed the procedure on all of them.

Perez has been out since the middle of spring training,when he tore the meniscus in his left knee.

The injury to Paulino is a devastating blow to the Royals, who have struggled to put together a consistent starting rotation all season due to injuries.

Paulino had revitalized his career in Kansas City, which acquired him from Colorado for cash last May. He opened the year on the DL because of a strained left forearm, but was 3-1 with a 1.67 ERA in seven starts, including four outings in which he didn’t allow a run.

He was coming off six innings of three-hit ball against Oakland when he hurt his groin in the first inning June 6 against Minnesota. Paulino landed on the DL again a few days later, and was on a rehab assignment at Class AA Northwest Arkansas when the elbow injury was discovered.

He was pulled after throwing 54 pitches in three innings Wednesday night.

Sports, Pages 22 on 06/23/2012

Upcoming Events