More ankle surgery for Flintoff could put an end to his season

Flintoff had been hoping to prove his fitness for the third npower Test at Old Trafford next week but withdrew from Lancashire's LV County Championship match against Sussex this morning.

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The 29-year-old suffered further discomfort during practice yesterday and went for further assessment with the England medical staff.

ECB medical officer Dr Nick Peirce said: "Andrew Flintoff has undergone rigorous fitness testing over the past two days, most recently 30 minutes of net bowling on Tuesday, but has reacted to the testing with further discomfort in his left ankle.

"Despite intense conservative treatment and rehabilitation with England and Lancashire's medical teams, Andrew's ankle has continued to cause him discomfort when bowling at full capacity.

"As a consequence he will undergo an exploratory arthroscopy on his left ankle over the weekend."

England will learn more about the length of time Flintoff will be sidelined after the operation.

Flintoff has twice had surgery for unrelated problems on the same left ankle in the past three years.

Flintoff said: "Obviously I'm bitterly disappointed to face another operation on my ankle as I really thought I was making progress with the injury over the past few weeks.

"I've been working really hard on my game and the rest and rehabilitation appeared to be helping the ankle but after giving it a strong workout this week, it now seems that an operation is the only option. "Having bounced back from ankle surgery before I know how much work is ahead of me but I'm desperate to get back playing for England and determined to overcome this setback as soon as possible."

Flintoff was left out of the first two Tests due to his inability to bowl at full capacity on the ankle but he had hoped to prove his fitness playing for his county.

He played as a specialist batsman last week but missed back-to-back Friends Provident Trophy matches over the weekend to work in the nets. England had hoped he would be able to bowl in the match at Hove starting today but Lancashire coach Mike Watkinson admitted he could not bowl untroubled.

Watkinson said: "He has rested for a couple of weeks, come in hard and is still feeling some discomfort."

One of the UK's leading arthroscopic surgeons, who specialises in the type of operation Flintoff is to undergo, believes the recurring problems with Flintoff's ankle are not unexpected.

Simon Moyes, who operates out of the Wellington Hospital, said: "A large number or percentage of soft tissue ankle injuries like Freddie's, some research suggests it can be up to 50 per cent, don't settle down and therefore it's not surprising that Freddie's ankle is still giving him problems, despite his rigorous rehab programme.

"Although he's had an MRI scan of his ankle joint, and these scans are excellent, they still miss anything up to 20 per cent of problems within the ankle joint.

"His proposed ankle arthroscopy is, from a diagnostic point of view, virtually 100 per cent accurate. If they weren't certain of the diagnosis of the problem beforehand they certainly will be sure after the arthroscopy."

But Moyes believes it could be six weeks before Flintoff is back to full fitness following surgery.

He added: "The likely common causes for Freddie's ongoing ankle problems would include localised inflammatory problems, bands or shelves of scarred tissue and cartilage problems.

"The surgery is performed through two or three tiny holes under a general anaesthetic and the instruments used for this are extremely small, normally 2-3.5mm in diameter so it is normally performed as a day case.

"It's successful for the aforementioned problems in 85 per cent of cases and the fastest time in my view that Freddie will be back to full fitness is six weeks."