In 2007 Patterson started the year dismally, going 1-5 in seven starts with an ERA of 7.47. He went back on the DL on May 7, with elbow inflamation. He didn't pitch the rest of the season, eventually opting for surgery in September.
Patterson had a breakout season in 2005, posting a 9-7 record while setting career bests in ERA (3.13), innings pitched (198.3) and strikeouts (185) in 31 starts. On August 4 of that year, he pitched his first career complete game shutout against the Los Angeles Dodgers, with Washington winning that game 7-0.