LOS ANGELES _ The Royals received a lift on Tuesday as starter Danny Duffy re-joined the rotation in Seattle. On Friday, however, Royals manager Ned Yost revealed that his club may have to compete without another starting pitcher for the rest of the season.
Nathan Karns, on the disabled list since May, could be headed for season-ending surgery to address thoracic outlet syndrome, Yost said on Friday.
Thoracic outlet syndrome is a neurogenic condition caused by the compression of nerves near the neck and shoulder. It can cause numbness in the fingers and soreness in the arm. Last season, it felled reliever Luke Hochevar and Royals prospect Kyle Zimmer. Now Karns, acquired in the offseason in a trade that sent Jarrod Dyson to Seattle, may be the latest pitcher to have the operation.
"He's having trouble with kind of the same thing (Hochevar) went through last year," Yost said. "We were hopeful that maybe it wouldn't require thoracic outlet-type surgery, but it's looking more and more like that's probably going to be the case."
Karns went on the disabled list in May after exiting a start early against the Minnesota Twins. He complained of tightness in the top of the forearm. The issue lingered for weeks, slowing his rehab process. The Royals' medical staff, Yost said, believes that thoracic outlet syndrome is the root cause.
"Now we're kind of circling the wagons," Yost said, "trying to see where we're at with him."
Karns, 29, has posted a 2-2 record and 3.43 ERA in eight starts this season. He struck out 49 while issuing 11 walks in 442/3 innings.
Yost stressed that surgery is not the definitive outcome, but it appears likely. Karns threw a bullpen session on Thursday in Kansas City and experienced more issues. He is set to see a thoracic outlet specialist in the coming days.
The loss of Karns would leave a sizable hole at the back end of the starting rotation. At the moment, left-hander Travis Wood has stepped into the role after a series of young starters, including Jakob Junis, Eric Skoglund and Matt Strahm, experienced varying levels of success. Wood allowed two earned runs in four innings in his first start last Sunday. He will not make his next start until after the All-Star break. For now, the Royals cannot count on Karns coming back.
The news on Karns came on the same day that Strahm underwent season-ending surgery on his torn left patellar tendon. Strahm is expected to be healthy for spring training. If Karns undergoes surgery, he, too, would be out until spring training, Yost said.
The loss could cause the Royals to explore possible rotation reinforcements in the trade market before the July 31st deadline. On Friday, the Royals at 44-40 entered a three-game series at Dodger Stadium in possession of the second wild card in the American League.
