Sunderland midfielder Jason McAteer faces the possibility of another hernia operation that could keep him out of action for a further two months.
The Republic of Ireland international played the first seven matches of the season for the Black Cats and only resumed training last week after recovering from a hernia operation.
But he suffered a set-back and was seen by a different specialist this week who has confirmed problems have arisen from the first operation and further surgery may be needed to cure the problem.
“Jason McAteer faces the possibility of another operation which is going to keep him out for a further six to eight weeks,” said Black Cats boss Howard Wilkinson.
“He has got an abdominal hernia as opposed to the one in the groin. It’s a very, very uncommon injury for a footballer, more common in rugby players, and there has been a side complication to it which on second opinion my require surgery.
“But we don’t know exactly at the moment until we have looked at other things and we will see how it pans out over the next couple of days.
“The problem has arisen because of the first operation and Jason was pretty low before he went for the second opinion. I hope now he is a bit more positive in the sense that the situation has been cleared up a little.
“I have spoken to him about it and that’s the way he has to view it. If it was something that was a total mystery and we didn’t know where we were going with it, then that is a problem. But at the moment we are almost certain of the route we are going to need to take.”
With America World Cup star Claudio Reyna ruled out for the rest of the season after a cruciate knee operation, Julio Arca still recovering from a long-term ankle injury and Gavin McCann suspended, Wilkinson is down to the bare bones in central midfield for Monday’s home game with Manchester City.
“At the moment what we have got in terms of regular central midfield players is Paul Thirlwell,” said Wilkinson. “Kevin Kilbane has being playing in there recently since we switched him, but we haven’t had much luck.
“Fortunately Kevin Kyle looks as though he has got away with what could have been a very, very nasty injury in Tuesday night’s Worthington Cup-tie against Sheffield United.
“The bruising is still very bad but the lacerations are superficial and fortunately did not require stitches. If they had done, then he could have been out for three to five weeks. At the moment therefore we just have the bruising to worry about.”