David Moyes says the loss of Lee Cattermole’s “leadership and presence” is a huge blow after the Sunderland midfielder was ruled out for four months.
The 28-year-old underwent hip surgery in the USA after a specialist found he was suffering from torn cartilage in his hip.
Cattermole is due back in the country this weekend ahead of a lengthy rehabilitation process, which could see him out until the middle of March.
Moyes hasn’t ruled out Cattermole, who has been struggling with injury all season, making a return towards the end of the campaign.
But he admits his absence is a major blow, with Cattermole the inspiration behind so many recent great escapes with Sunderland again battling for survival.
“Hopefully this time we will get to the bottom of it; we thought it was a hernia, then his back and some other treatment for him,” said Moyes.
“We sent him to a specialist in America last week who has found a tear in his hip in a cartilage, he has had the operation and is due back in the next day or two.
“We think he will be out for somewhere between three to four months.
“I don’t know if it is the season for him - maybe we get him back quicker.
“In all my time in football I have never heard of any of my players or when I was a player of anybody needing this operation so it is not something I know an awful lot about in terms of the recovery.”
Cattermole, who has only made three appearances this season, had returned to training in recent weeks but was not comfortable and the specialist in America diagnosed the problem.
Moyes added: “We have missed his leadership and his presence and what he brings.
“Every player offers something different and we will miss that.
“He has been out some days training and running and then the next was coming in saying it is sore.
“So, he was just never really comfortable. I think he was thinking he was close when he wasn’t.
“The specialist has found this tear, it is not something I have ever really heard of.
“I think this maybe behind his problems.
“Maybe this doesn’t cure what he is feeling but we have to hope this is the one.”
There was some more positive news on the injury front, though, with Jan Kirchhoff returning to training from a hamstring injury.
He won’t be involved against Hull City today but could feature for the reserves against Manchester United on Monday night.
Jack Rodwell and Fabio Borini also won’t be involved, while Steven Pienaar serves a suspension after his red card against Bournemouth.
“Jan has trained this week,” said Moyes.
“I might look to see how he is and play him in the reserves on Monday night, we could do with getting him back in amongst it.
“Vito and Seb are back in amongst it too.
“We have some positives on that front and they are closer to being involved and in the squad.
“We have a few other options. Adnan Januzaj gives me an option. Wahbi Khazri too.
“It is disappointing to lose Steven Pienaar, though, as he has given us some calm and composure.
“We will miss him. It gives someone else an opportunity.”