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Sports

Alex Rodriguez had knee, shoulder work in Europe

When Alex Rodriguez informed the Yankees last month that he was interested in traveling to Germany to pursue a fairly new medical procedure, they were understandably concerned.

Twice in recent years team officials had been caught off guard when they learned that players under contract had undergone medical treatment of which they were not aware.

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One of those players was Rodriguez, who initially informed the Yankees in December 2009 that he had not been treated by Anthony Galea, a Toronto doctor who was under criminal investigation in the United States over suspicion that he had provided athletes with performance-enhancing drugs.

But it turned out that Galea had treated Rodriguez after his hip surgery in early 2009. This past July, Galea pleaded guilty to a felony charge of bringing unapproved and mislabeled drugs into the United States, and this month he was sentenced to time served by a federal judge in Buffalo, N.Y.

Meanwhile, last spring, the Yankees found out that Bartolo Colon had undergone an experimental stem-cell procedure in 2010 to treat injuries to his elbow and shoulder by a doctor who said he sometimes used human growth hormone in his treatments, but not in Colon’s case.

The Yankees, who had signed Colon in January, were unaware of the procedure until the pitcher’s agent, aware that The New York Times was working on an article about it, notified the team.

So this time around, with the 36-year-old Rodriguez looking to deal with various ailments in the wake of an injury-hampered 2011 season, the Yankees made sure to investigate the treatment he was seeking.

‘‘We took what we felt was every step in the process to educate ourselves, vet the process, understand it to the best of our abilities,’’ Brian Cashman, the team’s general manager, said in a conference call Wednesday. ‘‘There was a lot of work, a lot of homework.’’

The procedure, known as Orthokine, was recommended to Rodriguez by Kobe Bryant of the Los Angeles Lakers, Cashman said. Rodriguez contacted the Yankees’ training staff in early November and asked them to look into the treatment, which is similar to platelet-rich plasma therapy, a blood procedure that has gained popularity among athletes in recent years and has been used by Galea, among others.

The Yankees asked Chris Ahmad, their team physician, to research the procedure and the doctor in question, Peter Wehling of Duesseldorf, Germany. Admad also talked to the Lakers’ staff about Bryant, who was treated by Wehling last summer.

‘‘The more our doctor researched it, the more impressed he was with this guy’s credentials and his reputation,’’ Cashman said of Wehling. ‘‘He’s considered quote-unquote the best.’’

The Yankees also reached out to Major League Baseball, Cashman said, ‘‘to make sure there was a complete comfort level that there was nothing in this process utilized that violated the drug program.’’

Dr. Gary Green, Major League Baseball’s medical director, said Wednesday that clubs regularly conferred with the commissioner’s office about medical issues.

Speaking generally, Green said his office would never formally approve or disapprove a drug or procedure. Teams and players are entitled to ask for his opinion, but they must take responsibility for their own decisions, he said.

The research and discussions were sufficient to satisfy the Yankees’ concerns, and Rodriguez traveled to Duesseldorf on Dec. 5. He stayed five days for treatment on his left shoulder and surgically-repaired right knee.

Afterward, the Yankees received a signed statement from Wehling assuring them that no substances banned under the drug programs followed by baseball and the World Anti-Doping Agency had been used.

‘‘There appeared to be no downside,’’ said Cashman, while emphasizing he was not an expert on the science of the procedure. ‘‘There appeared to be some evidence, or a lot of evidence, that there is a significant upside to its ability to enhance the anti-inflammatory effect in the joint.’’

The effectiveness of platelet-rich plasma therapies, which involve injecting parts of a patient’s blood into an injured area to catalyze the body’s instincts to repair tissue, has recently been put into some doubt.

‘‘It hasn’t been the panacea we thought it could be,’’ said Dr. Dennis Cardone, an associate professor of orthopedics at New York University. ‘‘It has been sliding down in popularity. The recent studies have just not been good.’’

Orthokine, Cardone added, differs from other types of platelet-rich therapies because it isolates a protein that has anti-inflammatory properties. Still, he said he was not impressed by the existing studies on the effectiveness of the procedure.

‘‘It’s about anti-inflammatory and pain-relieving effects,’’ he said. ‘‘There’s nothing at all out there that shows it can heal or reverse the ill changes present in a joint.’’

The Yankees were willing to let Rodriguez try, though. Rodriguez had surgery to repair a tear in his knee last July. He appeared in 99 games last season, batting .276 with 16 home runs and 62 runs batted in. Whether he will ever again be the slugger he once was is open to question.

It is also unclear if Rodriguez will face future problems in connection with Galea.

Rodriguez was questioned by baseball’s investigators about Galea and testified before a federal grand jury that was investigating the doctor. As part of his guilty plea, Galea is cooperating with federal authorities. And baseball’s investigators have continued to try to find out more about the case.

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