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After only 20 games, Miguel Sano's 2022 season might have ended.

The first baseman is back on the 60-day injured list for the second time this season, both for a left knee injury. He played only 17 games in April before hurting his knee while celebrating a walk-off victory. He had surgery to repair a torn meniscus in early May and rehabbed in Florida and in St. Paul before making a brief three-game appearance back at the MLB level.

While it's possible he could return for the end of the regular season or potentially the playoffs, both manager Rocco Baldelli and Derek Falvey, president of baseball operations, weren't ready to make that call.

"We're evaluating a lot of options, and obviously the move we made today makes it challenging to imagine that," Falvey said of Sano's 2022 prospects. "… We had some conversations with his agent, with him. There are other procedures being considered. And I don't want to speak on those until we know exactly what that's going to be."

Further imaging showed cartilage damage in his knee has progressed, and Sano is now weighing going through some aggressive treatments or having another surgery. The team knew of the issue before Sano had the operation to repair his meniscus, but it wasn't as bad then.

Sano has been a prominent fixture for the Twins since 2015 after developing in the Twins' system. And while he has put together some incredible performances — like in 2019 when he crushed 34 home runs and 79 RBI with a .922 OPS — he has also struggled at the plate. In his few games this season, he was hitting .083 with 25 strikeouts.

Sano's contract ends after this year, unless the team picks up a $14 million option. The buyout is $3 million. So should Sano not return later in 2022, his 13-year tenure with the Twins could have already expired.

The regular season ends October 5.

Kirilloff sidelined again

Alex Kirilloff's right wrist has once more put him on the 10-day IL. The left fielder/first baseman had season-ending surgery to fix a torn ligament there in 2021. But it didn't fully solve the issue, and Kirilloff has already had two cortisone injections in 2022 — most recently during the All-Star break — to help with the pain.

The first one seemed to work, as Kirilloff played most of June and July, hitting .295 and .254 in those respective months. But the second one hasn't seemed to have had the same effect. Kirilloff said swinging is the most bothersome activity.

Baldelli said the new imaging didn't reveal any new problem, just continued inflammation.

"But that doesn't change the symptoms that he's feeling. And going forward, he's going to continue to meet with the wrist specialists," Baldelli said. "I can't tell you that we know exactly what the next step is going to be. … There's multiple options. That's going to be up to the medical staff and AK to make a decision going forward. We knew he wasn't going to be able to swing and take the field and be an offensive player at this point. It was a move that had to be done."

Baldelli added he is hopeful Kirilloff can still contribute this season and return to the form he has been in for the past two months. Jake Cave came up from Class AAA St. Paul to take Kirilloff's spot on the active roster. Cave has played 281 games for the Twins since 2018 and is hitting .273 as an everyday player for the Saints this season.

To make room for Cave on the 40-man roster, the Twins designated reliever Jharel Cotton for assignment, a move the Twins have made several times this season. Cotton has a 2.83 ERA through 35 innings this season, including his 2 2/3 innings against Detroit on Monday, where he didn't give up a hit or a run with three strikeouts.

The Twins also had to designate Monday spot starter Aaron Sanchez — who allowed only four hits and two runs in his five innings — for release or assignment to make room on the 40-man for Michael Fulmer, who walked his way to the home clubhouse in Target Field after the Tigers traded him to the Twins at the deadline. There will be other roster moves made Wednesday to accommodate for the various incoming traded players.

Buxton, Garlick nursing injuries

For the second consecutive game, Byron Buxton was not in the lineup Tuesday. The center fielder has dealt with right knee patellar tendinitis for the whole season and has needed some extra time away after playing in all three games in the outfield during the recent road trip in San Diego.

"Buck is feeling some, I would say, a little bit of added discomfort from where he was at a few days ago," Baldelli said. "… We're going to have him looked at thoroughly today, just to see what the upcoming week is going to look like. He's sore, and that's probably a mild way of putting it."

Further testing the outfield depth, Kyle Garlick left Monday's game early, still feeling a rib injury he picked up in San Diego. Baldelli said Garlick has a "very painful" cartilage issue around his sternum.

"He's going to get a lot of treatment and take care of himself and see what the next couple of days look like," Baldelli said. "It could be a couple of days before he's back and doing anything."