Andrew Flintoff faces knee op next week amid doubts he will ever be the same again

It is understood that Flintoff will have an operation on his troublesome right knee on Tuesday — the seventh time he will have gone under the knife during his international career.

The England and Wales Cricket Board were remaining tight-lipped about Flintoff today but another operation would pose more questions than answers for the sport's chiefs.

It seems inconceivable that the ECB were unaware of the state of Flintoff's knee, given the huge attention which has been focused on it during this Ashes series.

That being the case, why was Flintoff chosen for the two Twenty20 internationals against Australia later this month, as well as the seven one-day games against the tourists and the ICC Champions Trophy?

Instead of looking forward to seeing their hero on as many as 10 occasions over the next three and a half weeks, cricket fans in England may have to wait a year to watch Flintoff play — and they can only wonder what state they will find him in.

Two of Flintoff's former England team-mates, Darren Gough and Michael Vaughan, both struggled to recapture their best form after suffering from knee trouble. Vaughan took almost a year to recover from his operation in 2006, and he continued to struggle with knee problems thereafter.

Derek Bickerstaff, an orthopaedic surgeon who operated on Vaughan and Gough, was cautious about Flintoff's prospects of making a full recovery.

His condition is known as a chondral defect, which means that bone is rubbing against bone in is knee, and Bickerstaff said: "For footballers this is a career-ending condition. It is like a filling a hole in plasterboard with grout. As a surgical procedure it is very simple. But the rehab is very, very slow. Patients need to avoid high-impact pivotal work for at least three to six months.

"It [success] depends on the location and size of the lesion. If it is 10mm and in an area of the knee that is not taking full weight then it could be 80 or 90 per cent successful.

"Even then if you look five years down the line then only around 60 per cent are still working.

"But if the lesion is 20mm and is right in the middle of the knee then the chances of it working are only 50-50. He will never be able to manage long spells of bowling and after the operation he will only be able to manage four to six overs at a time.

"If he were a batsman, I would be more optimistic but as a big lad, pounding in and bowling you have to be very cautious with his rehabilitation programme."

Flintoff has expressed a desire to become the best limited-overs cricketer in the world, and the shorter forms of the sport should not put excessive strain on his knee.

Yet despite that factor in his favour, it is difficult to imagine a cricketer with so many injuries behind him reaching the summit again.
When Flintoff returns, perhaps he will be able only to show flashes of the talent which pushed him close to greatness.