Sunderland midfielder Lee Cattermole has been ruled out for at least four months after undergoing surgery on a hip injury.
The 28-year-old has been limited to just two Premier League starts for the Black Cats so far this season having been troubled by the long-standing hip problem.
Cattermole travelled to the United States to undergo surgery on Monday, and he will now miss the next four months of action, keeping him sidelined until March at the earliest.
"Lee Cattermole had an operation in America on Monday on a torn cartilage in his hip and will be out for four months. He's out there just now, coming back in the next day or two, I think," manager David Moyes told reporters.
Sunderland currently sit bottom of the Premier League table with just five points from their 11 outings so far this season.
