Andy Murray is seriously considering having surgery for the second time in four years to rescue his career after nagging hip pain forced his late exit from the US Open, which begins on Monday.

Consultation with several specialists has failed to deliver a solution to the unspecified problem – most probably a bone spur but possibly arthritis – which first struck in the French Open semi‑finals in May, then cut him down in the Wimbledon quarter-finals.

It is clear six weeks of rest and rehabilitation since losing against Sam Querrey at the All England Club were not enough to ease the discomfort or provide the world No2 with sufficient lateral movement to compete. It is also obvious his problem was much worse than he let on at the time, when he claimed his pronounced limp was no different from the way he normally walked.

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Murray’s shock announcement on Saturday was not taken lightly. He left the call until 20 minutes before an emotional press conference in which he looked as dispirited as when he decided in 2013 to have an operation on his back after years of playing with the aid of painkillers. He took a few questions then returned to the Manhattan hotel accommodation he has been sharing with his brother, Jamie.

What he hoped would be a solid shot at a second US Open title after being handed the gentlest of draws disintegrated during the closing moments of a training session on Saturday with the Frenchman Lucas Pouille. Looking on with serious concern was Ivan Lendl, who had both hips replaced last year to enable him to resume as Murray’s coach.

It took Murray a year to recover properly from his first surgery but he looked to have been restored to full health when he won his third grand slam title and second Wimbledon championship last year. However, a charge thereafter to haul down Novak Djokovic as the No1-ranked player in the game, culminating in his first ATP World Tour Finals title in London in November, took its toll this summer.

One solution to his chronic hip problem could be platelet-rich plasma injections into the joint, which the former British No1 Andrew Castle tried, to no avail, when diagnosed with severe osteoarthritis after a long career. Eventually he had a metal hip inserted. If Murray goes under the knife again, at 30, he risks another long period of recovery. It is clear the only alternative is a lengthy spell away from the Tour, similar to the breaks chosen by Rafael Nadal, Roger Federer to spectacular effect last year and, most recently, Djokovic and Stan Wawrinka, who only a year ago were contesting the title here at Flushing Meadows but have decided to rest until 2018.

Murray is aware this is the biggest turning point in his career. He once said he could happily retire without winning a major or getting to No1 as long as he was satisfied he had given his best. Since winning the boys’ title here in 2004 he has done that time and time again, acknowledged as one of the sport’s great survivors and gathering three majors as well as two Olympic gold medals and a 41-week reign as world No1, which he surrendered to Nadal last week, in his absence from the Tour.

However, Murray’s famous fighting qualities have dimmed. Once he was almost unbeatable when holding a 2-1 lead in five-setters; over the past year he has lost four times from that position. He does not need reminding that the quality that separates him, Nadal, Djokovic and Federer from the herd is their ability consistently to repulse the challenge of younger contenders over the longer distance.

Yet Juan Martín del Potro came from 1-2 down to beat him in the Davis Cup semi‑finals last year; Murray was 2-1 up before losing to Kei Nishikori in the quarter-finals of this tournament; this year he led Querrey 2-1 at Wimbledon; and he held that advantage over Wawrinka at Roland Garros, before fading in the match he identifies as the one where his hip problem first flared.

This is not yet a full-blown crisis but those defeats mark a worrying trend.

With a second child on the way Murray might reluctantly consider that his life as a professional athlete is drawing to a quicker close than he would like. He has compiled a strong investment portfolio and would have no problem turning his immense tennis knowledge to good cause, although he might not be drawn to sitting in another player’s box.

His preference remains staying in the sport he has known for so long. He is one of the game’s most dedicated trainers, having turned a scrawny teenage frame into a powerhouse that has carried him through so many marathon matches. He revels in the struggle and would miss it desperately. An operation may well be the only way to extend his career.

However, surgery is risky, especially so late in his career. Federer said he thought long and hard about opting to have his knee repaired last year, although he made a comeback that surprised even him, winning the Australian Open on his return, then Wimbledon and he is now staring at a shredded draw that could open his path to a seventh US Open title, the 20th grand slam of his long career.

Federer, who opens his campaign on Tuesday against the exciting young American prospect, Frances Tiafoe, may have to get past Nick Kyrgios, Dominic Thiem or Juan Martín del Potro to get to a semi-final against Nadal. The Spaniard, who has never played his Swiss rival here, has a slightly easier path to the final weekend, beginning on Tuesday against Dusan Lajovic. Tomas Berdych, David Goffin and Grigor Dimitrov are in his quarter, so there is work to be done.

It is a job Murray would have relished. He had been gifted a draw as easy as in any slam he has played. Tennys Sandgren, however, now plays Marin Cilic, who inherits the Scot’s second spot in a reshuffle of the seedings.

It is not just parochial concerns that make the US Open a little poorer this year. Whenever he leaves, Murray will be hugely missed.