Lee Cattermole will be out of action for four months after undergoing surgery in America to address a long-standing hip problem. The Sunderland captain, who has made only three appearances this season, had a procedure to repair a torn cartilage in his hip on Monday.

David Moyes said: “Lee Cattermole will be out for four months. He’s coming back in the next day or two.”

The news came as a significant blow to Moyes, who has been without one of the club’s most consistent performers for much of his reign on Wearside. The setback arrived after lengthy treatment that eventually got to the root of the problem.

Moyes said: “It’s a big blow because we have had hernias, we have had epidurals, we have had other things done but, by all accounts, we have found a tear in his cartilage in his hip which has now been repaired.”

Cattermole, who joined Sunderland in a £6m move from Wigan during the summer of 2009, has been a key figure in the club’s survival fights over the past four years. He was last able to take to the field in the 3-2 Premier League defeat by Crystal Palace on 24 September.