Buxton undergoes second knee surgery in effort to return to center?

MINNEAPOLIS -- Ultimately, Byron Buxton never did make it back to center field in 2023 -- but the goal remains to get him there.

The hope is that a second knee surgery will help. Buxton underwent an arthroscopic procedure to excise the plica (a membrane flap) in his right knee on Friday, president of baseball operations Derek Falvey said. The Twins believe the surgery will alleviate the issues related to the patellar tendinitis that limited and pained Buxton throughout this season.

Unlike the arthroscopic cleanup procedure on the same knee last September that prevented Buxton from having a normal Spring Training and left his status for Opening Day 2023 in question, this procedure is expected to carry a much shorter recovery time. The Twins hope that Buxton will begin physical therapy within weeks as part of a close to normal offseason buildup ahead of a healthy Spring Training in '24.

“Our hope and our expectation and our goal is to get him ready to play center field,” Falvey said. “That’s his focus. That’s what he wants, and that’s what we all want. So that’ll be our mission through the offseason -- to get him there.”

Alex Kirilloff, whose right shoulder issues bumped him from the Twins' playoff roster during the ALDS, will also undergo labrum repair surgery on the shoulder on Oct. 24 with Dr. Neal ElAttrache, with a recovery timetable to come following the procedure.

This now marks consecutive offseasons for Buxton in which he’ll have undergone surgery on his right knee -- but according to Falvey, the Twins feel the two years involved unrelated issues.

Last season, Buxton dealt with pain and swelling in the right knee from Spring Training on, requiring his knee to be drained at points even as he played 92 games, hit a career-high 28 homers and started the All-Star Game in center field. That season ended prematurely in late September, when he underwent the surgery to clean up the fraying and scar tissue in the joint.

This year, the issue has been more related to patellar tendinitis symptoms and pain in the knee, which was later linked to inflammation and irritation to the plica that led to Buxton being pulled off his rehab assignment with Triple-A St. Paul in September as the Twins attempted to ramp him up to play center field. But he never needed to have his knee drained, as he did in ‘22.

“I know we've been in the weeds on a lot of things Byron medical for the last couple of years, but I think there have been different issues that have presented,” Falvey said. “This one wasn't something that existed a year ago in terms of the evaluation and where things were.”

Falvey indicated the Twins don’t necessarily feel there’s any underlying issue with Buxton’s right knee that has made it prone to these injuries, but uncertainty has characterized this process from the start -- both internally and externally.

The belief was that starting Buxton at designated hitter when this regular season began would ease the stress on his knee to the point where he could eventually ramp up to play center field when he was able.

But from just about every standpoint -- health, performance, roster composition -- that plan did not work.

Buxton’s knee never did get better, and he was still simply “treading water physically” as late as the end of June, manager Rocco Baldelli said at the time. Even after having spent the final two months of the season on the IL with a hamstring issue and, later, the knee recovery, Buxton’s return in Game 4 of the American League Division Series against the Astros was marred by pain, and he admitted afterward he wouldn’t have been able to play the field.

Buxton struggled to a .207/.294/.438 slash line in 85 games and never grew comfortable with the newfound mentality and routine required of the DH role, he acknowledged.

And by the end, there wasn’t even room for that lesser version of Buxton in that DH spot, as the Twins had to rotate Jorge Polanco, Matt Wallner, Edouard Julien and, later, Royce Lewis through to keep all of their most productive bats in the lineup on any given day.

“If you take a prime Byron Buxton and sprinkle it on top of what we were doing at the end of the year, that could be a very special type of situation,” Baldelli said.

But they just haven’t seen that “prime Byron Buxton” in some time, and there is an understanding that there still likely won’t be certainty to be found in this uncertain situation.

The Twins understood that when they traded for Michael A. Taylor as an insurance option before the ‘23 season -- and Taylor ended up starting 126 games in center field. They’ll likely have to forge a similar plan for ‘24, whether it’s in re-signing Taylor to a free agent deal or through some internal combination of Willi Castro and prospect Austin Martin.

Everyone involved -- Baldelli, Falvey, Buxton, all the others in that clubhouse -- know what a healthy Buxton can do for them, but try as they might, they still couldn’t establish proof of concept of that in ‘23. The hope is that this next procedure steadies the ship.

“Get healthy,” Buxton said after the Twins were eliminated from the playoffs on Wednesday. “Whatever it takes to just get me right.”