Pat Neshek's attempted recovery appears to be on the same trajectory as Francisco Liriano's in 2006 - meaning that we should get Neshek back in some pretty decent form by mid-2010. As important as Neshek was to the Twins' 2008 plans, he was just as important for 2009, and his absence changes the calculus for the Twins' offseason moves.
First of all, the Twins have lost all luxury they might have had in disposing of their present in-house options. I had been advocating that they make an effort to re-sign Dennys Reyes, but I think that's essential now. If Jose Mijares is going to be the primary 8th-inning setup man (and, after his splendid September, it's got to be his job to lose), and Craig Breslow is a 6th or 7th inning option, then the Twins will still need that matchup lefty to bring on in the middle of a dicey inning. Reyes has done the job against lefties for 3 seasons with the Twins, holding them to a .531 OPS, striking them out at a high rate and inducing a ton of grounders.
Say Nick Blackburn runs into trouble in the 6th inning, leaving the game with 2 on and only 1 out and the big lefty coming up. Reyes can come in and face him with a high probability of a strikeout or DP grounder. Jesse Crain could finish the inning against the subsequent right-hander, and you'd still have Breslow and Mijares available to pitch complete innings in front of Joe Nathan.
I'd been ambivalent about the Twins keeping Matt Guerrier around for next season. No longer. Though he melted down in the final 3rd of 2008, he was very effective for 3 and a half seasons before that. I don't doubt that he'll bounce back and pitch more like his old self in 2009, particularly if he's allowed to return to some lower-leverage situations. Boof Bonser should also be brought to spring training and given an opportunity to show that his strong finish to the season out of the bullpen was an indication of things to come.
The Twins should also be hesitant to trade away any of the AAA relievers who were performing well last season, including Bobby Korecky and Ricky Barrett. Those folks, along with Arizona Fall League participants Rob Delaney and Anthony Slama, should be invited to spring training and given the opportunity to compete for a spot in the Twins' 'pen.
There is ample payroll available for free agents, and so the Twins should look into some of the available right-handers. I would be interested in giving a shot to some of the veterans who are coming off recent injuries - guys like Brendan Donnelly, Keith Foulke or Jason Isringhausen. Each had tremendous stats prior to their DL troubles, and bring a wealth of experience working in high-leverage situations. One of them might be willing to join a contender for a low-base, high-incentive contract while he proves that he can still compete.
Finally, I think this takes any potential moves that would have involved a member of the rotation off the table. With question marks in the bullpen, the Twins cannot afford to put themselves in a situation where they might need to get more than 15 innings from their relievers every trip through the rotation. The 5 starters they have now are very likely to average more than 6 IP/start. The closer the starters can get to Joe Nathan, the better. Therefore, the Twins should only consider moving minor league pieces in a trade, which probably limits them to working with the very worst teams in the league. Otherwise, they should look to free agents to upgrade their roster.
Speaking of the worst teams in the league, it has been suggested that nobody from the Nationals would be untouchable. Third baseman Ryan Zimmerman would be another guy to potentially target - his career numbers are about on par with the Buscher/Harris tandem, but he'd be a bit of an upgrade defensively.