For now, multiple baseball sources said late Wednesday night, there is no final decision about what will happen with Daisuke Matsuzaka, or whether he will undergo Tommy John surgery that could spell the end of his Red Sox career.

The Japanese right-hander will meet with team officials on Thursday to decide on the best course of treatment for his sprained ulnar collateral ligament. Reports – first from Nikkan Sports, then from Yahoo! Sports and ESPN.com – suggest that Matsuzaka wants to undergo surgery as soon as possible based on the medical information he and his family have received. The Sox would seemingly prefer to see if the 30-year-old could return to the mound without a surgery that usually involves a rehab process of at least 12 months.

“We have to figure how to best go about this. The player or pitcher has to have some opinion, too,” said Sox manager Terry Francona on Wednesday. “But I think you’re always going to go about it non-operatively, first. That just seems like it makes sense to me.”

Perhaps the Sox and Matsuzaka will emerge from Thursday’s meeting seeing eye-to-eye on that notion. Or, perhaps the outcome of the meeting will be that Matsuzaka – who said after landing on the DL just over two weeks ago that it had become too painful for him to throw – does indeed undergo surgery.

Even if Matsuzaka doesn’t go under the knife, there appear to be few guarantees about when he might return, or whether he could be an effective member of the rotation. And, obviously, if he does need surgery, then he would be unlikely to return to the mound for the Sox until at least next summer, if ever.

That being the case, what are the Sox’ options at a time when Matsuzaka cannot be relied upon as a contributor in 2011?

STAY THE COURSE WITH WAKEFIELD AND/OR ACEVES

Matsuzaka was 3-3 with a 5.30 ERA in eight games (seven starts) for the Sox this year. The team isn’t exactly trying to replace a Hall of Famer in his prime.

Indeed, the two pitchers on the big league roster began the year as insurance for the rotation – Alfredo Aceves and Tim Wakefield – have combined for a 3-2 record and 4.34 ERA in eight starts. Certainly, barring injuries to other members of the staff, the Sox could be in relatively solid shape if they simply relied upon those two pitchers to assume Matsuzaka’s workload in the rotation going forward.

DOWN ON THE FARM

Perhaps the most significant development for the organization’s pitching depth – both in the rotation and bullpen – is that Felix Doubront is now healthy again after missing roughly three weeks due to a left groin strain. He pitched 3 1/3 scoreless innings of one-hit ball while striking out five and walking two in a start for Triple-A Pawtucket earlier this week.

On the year, he has a 1.59 ERA and .172 batting average against in five starts for the PawSox. The 23-year-old – who impressed the Sox during his 2010 major league debut – still needs to be stretched out, but the Sox would have significant faith in him as a depth option. Of course, with Rich Hill (the lone left-hander in the Sox bullpen) having left Wednesday’s Red Sox game with a left forearm injury, Doubront could also end up back in the big league bullpen in the near future.

Aside from Doubront, the rest of the team’s top minor league options are not on the 40-man roster. Kevin Millwood, who recently signed a minor league contract with the Sox, was unimpressive in his Pawtucket debut on Wednesday, allowing four runs on five hits and two walks in 2 2/3 innings. He struck out three.

According to PawSox broadcaster Dan Hoard (via twitter), Millwood’s fastball sat in the high-80s. At the least, it will take the right-hander (who had a 4.50 ERA in Double-A and Triple-A for the Yankees in April before opting out of his contract) time to get major league ready, if he is to be in position to contribute at all this year.

Other PawSox starters would appear closer to making a potential impact. Right-hander Kyle Weiland (4-4, 3.46, 57 strikeouts in 52 innings) seems likely to be in the majors no later than September.

Left-hander Andrew Miller (2-2, 2.47, .160 batting average against) has permitted one or no earned runs in seven of his 10 outings this year. Even though command remains an issue (34 walks against 39 strikeouts in 47 1/3 innings), he is showing at-times overpowering stuff, as in his most recent outing, when he tossed seven shutout innings and allowed just one hit and two walks.

Matt Fox, meanwhile, is amidst a solid run in which he has a 1.24 ERA over his last nine games (four starts), spanning 36 1/3 innings.

OUTSIDE THE ORGANIZATION

Wakefield and Aceves, of course, are with the Sox in no small part because the team wanted to avoid being in a position where it would have to be desperate to make a trade for starting pitching. For that matter, John Lackey is with the Sox in part because the team believed that he represented a rare case of an impact pitcher becoming available, something that rarely happens mid-season.

To a degree, recent seasons have defied the idea that impact starters aren’t available in the middle of the year. In 2008, CC Sabathia went from the Indians to the Brewers. In 2009, Cliff Lee was sent by the Indians to the Phillies. In 2010, Lee moved from the Mariners to the Rangers, while Roy Oswalt relocated from Houston to Philadelphia.

Even so, the Sox may not be in position to pursue elite starting pitching via trade even if it is available this summer. The team’s upper levels of its minor league system were thinned significantly by the Adrian Gonzalez trade, and so the team has few high-ceiling impact prospects who typically must be available if a team is to make a deal for a top pitcher.

The team seems unlikely to trade shortstop Jose Iglesias, given how much a part of the Red Sox’ future he is expected to be. Ditto Ryan Kalish (whose value as a chip will remain limited at any rate until he is ready to once again play in the outfield while recovering from a partial labrum tear).

Doubront would have some interest, though he with a ceiling as more of a mid-rotation starter than a front-of-the-rotation pitcher, he would not be able to serve as the centerpiece of a deal for a top player. Ditto Josh Reddick, who continues to show impressive tools in his big league callup but whose performance in his career to date has been inconsistent.

Moreover, there is the issue of whether the Sox would feel compelled to acquire an elite starter just because of the absence of Matsuzaka. In Josh Beckett, Clay Buchholz and Jon Lester, the team has three starters with sub-4.00 ERAs who possess top-of-the-rotation stuff (Lester’s recent struggles notwithstanding).

Given how good the top end of the rotation is (or should be), the team may be comfortable steering clear of a costly trade, and instead staying with options such as Aceves and Wakefield at the back of the rotation – pitchers who have shown every indication of being able to offer competent strarts and giving their team a chance to win.