REUTERS - Sunderland's captain Lee Cattermole has been ruled out of action for at least four months after undergoing surgery on a hip injury, the Premier League club confirmed.
The news is a huge blow to their chances of surviving another Premier League relegation scrap after a disastorus start to the season has left them bottom with five points from 11 games.
"Lee Cattermole has undergone hip surgery in the US due to torn cartilage and will be out for a minimum of four months," the club confirmed in a tweet.
The 28-year-old Cattermole has been ever-present in the Sunderland first team since joining in 2009, but injuries have restricted the industrious midfielder to just three appearances this season, the last of which was in September.
Manager David Moyes will also be without the injured winger Fabio Borini and midfielder Jack Rodwell for Saturday's league clash against 18th-placed Hull City.
Moyes hopes Sunderland's victory at Bournemouth before the international break will provide a springboard, and another win on Saturday could see them move above Swansea City.
"We've had a good couple of weeks and it felt good to win again. We've had great support and we want to keep winning," Moyes told reporters on Friday.
"I'm hoping we've put all the injuries behind us. The players are in good spirits and we want to do it again."
(Reporting by Shravanth Vijayakumar in Bengaluru, editing by Neil Robinson)