Owen Hargreaves was told by the surgeon Dr Richard Steadman that the damage to his tendons in both knees is worse than anything else he had seen in 35 years of work in his profession.
Hargreaves has described how his condition was worsened by his desire to play quickly after his acrimonious departure from Bayern Munich, with whom he had suffered a broken leg. "Part of the problem for me was my competitiveness," he said. "I was new to Manchester United and they had spent a lot of time, energy and money in getting me from Bayern Munich. I wanted to do well obviously. I came with symptoms [of tendinitis] but everyone said 'don't worry it will go' and so I always tried to be available. But playing on it made it worse. I wanted to play, though, so I played through it.
"After I broke my leg at Bayern they put me in a cast. The muscle deteriorates being in that and when I came out of it after six weeks and started to play again I don't think my muscle was strong enough."
Hargreaves felt he had overcome the problem in the last four weeks of the 2007-08 season and his game for England against the US on 25 May 2008 was the best he had felt. But his left knee began hurting again in preparation for the new campaign and the right knee was also troubling the midfielder. After appearing against Liverpool, Villarreal and Chelsea in September 2008, Hargreaves knew he needed surgery.
Only match time will tell him if he has resolved the problem but he believes so. "It is not about getting back for one game or for one day, I want to come back and be back for another six or eight years," he said.