Eaton has surgery to remove cartilage flap from ankle

PHOENIX - A month after losing him to what they hoped was a minor ankle injury, the Nationals finally figured out what exactly was wrong with Adam Eaton. That's the good news. The bad news: It required surgery to figure it out.

Eaton had arthroscopic surgery today in Green Bay, Wis., to remove a flap of cartilage that didn't show up in any of the three imaging tests the Nationals gave the outfielder over the last month but was the source of his pain any time he tried to run.

General manager Mike Rizzo wouldn't offer any timetable on Eaton's return to action, but said he'll need to spend one week without bearing any weight on the ankle, then spend another week wearing a walking boot before transitioning back into baseball activities. The sense, from the Nationals' perspective, is that Eaton will return this summer.

Thus ends the mystery of Eaton's latest injury, which occurred during an awkward slide across the plate April 5 at Nationals Park. He appeared in two more games after that before going on the 10-day disabled list with what was termed a bone bruise of the left ankle.

Eaton hoped to return quickly from the injury, but he was unable to ramp up his baseball activities without experiencing pain. He wound up getting opinions from three different doctors: Nationals team orthopedist Robin West, Baltimore specialist Lew Schon and finally Green Bay specialist Robert Anderson. Those doctors looked at three different images of Eaton's ankle (two MRIs and a bone scan) and found no cartilage problems. Anderson, though, recommended exploratory arthoscopic surgery, at which point the small flap was found and removed.

"We thought - the doctors thought - there was something not normal about the rehab process," Rizzo said. "There was a reason that, immobilized, there was no pain, but then when we took him out of the boot, every time he did baseball activities there would be sharp pain and inflammation. They thought that something was missing in the rehab, so they went in arthroscopically to see what was going on."

What Anderson found was an "unstable chondral flap" that appeared flat on the images but would get stuck into the "lateral gutter of the ankle" when he ran, causing inflammation and pain, according to Rizzo.

"That's why we could never get him over the hump when we got him out of the boot," Rizzo said. "Because this flap kept interfering and causing inflammation and pain. It correlates with all of the systems that he has, and Dr. Anderson said the surgery went great. The ankle is very stable, and it looks really good after the debridement and the cleanup of this lateral chondral flap."

Though Eaton sustained a major injury one year ago, tearing the ACL in his left knee and severely spraining his ankle, the Nationals don't believe this injury was a direct result of it. Rather, they believe he suffered this injury during that April 5 slide.

"I don't think it's related, but there was a lot of damage done last year," Rizzo said. "He had a clean bill of health coming in (to this season) with the ankle and with the knee. You saw him perform well before the play at home plate. Who's to say there wasn't something that happened with the original injury? He was clean to go, performing well. Then the doctors think the play at home plate is what caused the tear."

With Eaton sidelined for a while longer, the Nationals will continue to mix and match in left field. Manager Davey Martinez said Matt Adams and Howie Kendrick will both see time in left field (in addition to the time they each spend at first and second bases, respectively). Andrew Stevenson is starting tonight against the Diamondbacks. Brian Goodwin, meanwhile, has resumed swinging a bat in West Palm Beach and could ramp up his rehab from a bruised wrist.

"These guys are all playing well," Martinez said. "We miss Adam, but these guys have stepped in and have done the job."