The Washington Times - June 11, 2013, 07:27PM

DENVER — Bryce Harper’s visit with Dr. James Andrews in Pensacola, Fla., on Monday confirmed what the Washington Nationals had initially diagnosed in the outfielder’s left knee: patella bursitis.

Harper was given two injections, one of platelet-rich plasma and another of cortisone, in order to help combat the swelling and inflammation that has plagued him for two weeks. His knee was placed in an immobilizing brace and the 20-year-old will be reevaluated by the Nationals’ doctors in one week.


Another MRI done on his left knee again showed no structural damage to the ligaments or cartilage, but a specific timetable for when he may be able to return to the Nationals’ active roster remained unclear. They must first see how he responds to this treatment.

“He didn’t have surgery, contrary to popular belief,” said Nationals head trainer Lee Kuntz, who provided the update on Harper.

“These are all good things. We want him to rest the knee, that’s why we put him in the immobilizer. We’ll reevaluate him in one week’s time and if everything’s a go, then we will resume activity with him and get him going as quickly as we can.”

Multiple pictures of Harper circulating on Twitter, taken by fans at the airport on Monday night as he made his way back to D.C., showed the outfielder wearing a large, bulky brace. That, and the Nationals’ relative silence on his prognosis until late Tuesday afternoon, led to speculation that he had undergone a procedure while seeing Andrews.

That presumption was incorrect, and Kuntz said that Andrews agreed the team had taken the right steps in their treatment up to this point.

Harper, who was eligible to come off the disabled list on Tuesday, had previously said he did not want to get a cortisone injection, preferring not to put the corticosteroid into his body. But Kuntz said the decision to do so was made after Andrews and Nationals medical director Wiemi Douoguih discussed the possible courses for action with him. 

Cortisone is an anti-inflammatory drug, used to reduce swelling and pain. It comes with risk, often if it’s used to mask pain in an area that could lead to further injury if a player continues to do damage while playing because he is not feeling pain. Ryan Zimmerman received multiple cortisone injections in his AC joint in 2012, and he underwent arthroscopic surgery to clean the area out in the offseason.

But because Harper’s knee is structurally sound, the drug will not be masking any muscular, ligament or cartilage issues.

The platelet-rich plasma shot is an injection of a person’s own blood, which has been extracted and spun down to become highly concentrated white blood cells. It was used to help stave off a possible infection that could come from having the cortisone injected into the bursa sac, Kuntz said.

“With PRP, a lot of times that causes an inflammatory response, it’s kind of counterintuitive,” Kuntz said. “But cortisone reduces inflammation. The reason they gave him the PRP is because of the added white cells to reduce the risk of any infection. A lot of times when you inject the bursa, stick a needle in it, things can happen so it has a bacteriostatic effect. It protects the knee.”

Harper will wear the brace when he is up and about during the day for the next week. He does not need to wear it while he sleeps, Kuntz said, and it’s mostly to serve as a reminder for him not to put stress on the knee while it heals. 

“A lot of times when kids hurt something the doctor will put them in a cast,” Kuntz said. “Why, because it’s broken? No, so he stays off of it. So we put him in an immobilizer just to allow him to rest.”

The news, for all intents and purposes, could be categorized as “good.” But for the Nationals, Harper completely changes the dynamic of the lineup they can put on the field, and having him out leaves them with a hole. Getting him back healthy remains paramount to their success.

The hope is that he is now one step closer to being able to do that.

“I’m not relieved,” said manager Davey Johnson. “I wish he was out there right now playing. It’s a tough thing.”