BOSTON — All the offseason work, rehab starts and minor league outings finally paid off for Daisuke Matsuzaka.

Matsuzaka returned from the disabled list and turned in his best start of the season, and Cody Ross drove in three runs, leading the Boston Red Sox to a 5-1 win over the Kansas City Royals on Monday.

Matsuzaka (1-3), who started the season on the DL after Tommy John surgery in June, earned his first big league win since May 16 of last season.

The Japanese right-hander made eight rehab starts before he rejoined the rotation in June, but he went back on the DL in early July with a strained neck muscle. Then it was back to the minors for another five starts.

“I tried back in June and I didn’t get the results I wanted. I didn’t feel like I’d be able to come back strong again this season,” he said through a translator. “I went back to my final two rehab starts and threw the ball really well. I knew if I could do that up here the results would come.”

Matsuzaka gave up an unearned run and five hits, walking two and striking out six over seven innings in just his sixth start of the season.

The Red Sox took 3 of 4 in the wraparound series and won for the second time in three games since trading Adrian Gonzalez, Josh Beckett and Carl Crawford to the Dodgers on Saturday in a salary-dumping, nine-player deal.

“Obviously he’s going to get another start — two, three, four or five,” Boston Manager Bobby Valentine said. “He might finish strong throwing like that.”

Jacoby Ellsbury had a solo homer and a double for Boston, which opens a nine-game West Coast trip Tuesday night against the Los Angeles Angels.

It was the first time Matsuzaka has pitched more than six innings in a major league game since April 2011.

“When I had to go back on the DL in July it was very disappointing, especially when I didn’t expect my body to react the way it did,” he said. “But the encouraging part was it wasn’t my elbow. I didn’t know if I’d be able to come back strong this year, but I felt better than I did before I had Tommy John.”

The Red Sox won for just the seventh time in 19 games.

“He threw his slurvy slider inside on right-handers really well,” Royals Manager Ned Yost said. “I mean he really executed that pitch well a number of times. So when you’re sitting, looking out, away on him and he throws that slider that starts at you and breaks back on the corner of the plate, it keeps you off balance really well, and that’s what he did.”

Luke Hochevar (7-12) took the loss, giving up five runs and eight hits in his second complete game this season.

Boston broke a 1-1 tie on Ross’ two-run single in the third inning. Scott Podsednik and Dustin Pedroia each singled, then advanced on a wild pitch before Ross hit a drive high off the Green Monster. Ross was thrown out by Alex Gordon trying to stretch it into a double.

The Red Sox added two runs in the sixth. Ross had an RBI double off the left-field wall, then scored when newly acquired first baseman James Loney singled to make it 5-1.

Loney went 1 for 4 in his second game after coming over in the trade with Los Angeles.

Matsuzaka, in the final year of a six-year, $52 million contract, mostly spotted his fastball with a slider and cutter to keep the Royals off balance.

He was most impressive when he worked out of a first-and-third, one-out jam in the sixth, getting Mike Moustakas swinging on a tailing 94 mph fastball to end the inning.

“He was throwing a good cutter,” Kansas City designated hitter Billy Butler said. “He was locating and had pretty good velocity on his fastball whenever he needed it.”

The Royals took advantage of an error to score a run without a hit in the first. Jarrod Dyson opened the game with a walk, stole second and advanced when second baseman Pedroia was charged with an error when he didn’t catch a somewhat high throw. Gordon followed with a sacrifice fly.

Ellsbury’s homer in the bottom half, a drive that bounced on the top of the short right-field wall and into the stands, tied it 1-all.