West then came up big with 29 points and 10 rebounds as New Orleans routed San Antonio 100-75.
West hurt his right ankle during the Hornets' victory at New York on March 3. He finished that game, but missed New Orleans' next three contests. He went into Wednesday's game averaging 19.7 points and 9.0 rebounds this season.
While West was making his first start in four games, the Spurs' Bruce Bowen made his 500th consecutive start. Bowen's streak, which began Feb. 28, 2002, is the longest in the NBA.