It was the news that everyone associated with Tottenham Hotspur had been fearing. James Maddison will require surgery on a ruptured anterior cruciate ligament (ACL) in his right knee.
This is his second knee injury in three months, and is much more serious than the one he sustained in May, which did not need an operation. He will be out for much of the 2025-26 season.
It goes without saying what a devastating moment this is for Maddison.
That previous knee injury happened in the first leg of their Europa League semi-final against Bodo/Glimt on May 1, forcing him onto the sidelines for what would have been the biggest match of his career, the victory over Manchester United in that competition’s final.
He spoke publicly about how he was “absolutely gutted” to miss that game in Bilbao. He still played an active, supportive role with the squad. The sight of him embracing a tearful Son Heung-min at the final whistle became one of the iconic images from the evening, as Maddison told Son, his captain and close friend, how much he meant to him. But like any player, he would have dearly wished to be on the pitch playing that night.
Maddison had been working so hard this summer to make sure that he could play a full part in Thomas Frank’s first season as Spurs’ head coach.
Despite fears that previous knee injury would impact his pre-season, the 28-year-old was involved on the summer tour to Hong Kong and South Korea, making an appearance in the opening win over Arsenal and then again coming on from the bench three days later against Newcastle United. But it was only 10 minutes into that appearance that he went down with this new knee injury. He will not return to competitive football until well into this season.
This would be painful for any professional player, leaving them out of first-team football for so long. But even more so in the case of Maddison, because of how uniquely important he is to Spurs. And because of how good he was looking at the back end of last season, just before that first knee injury.
Cast your mind back to the start of 2023-24 under new coach Ange Postecoglou, just after Maddison had joined from Leicester City. In those first 10 games, he was sensational. Given the vice-captaincy and the No 10 shirt at the start of the season, he instantly made ‘Angeball’ work, taking creative leadership in the middle of the pitch.
But then, in the 4-1 defeat to Chelsea on November 6 — the day Spurs’ whole season turned — he went down with an injury to the deltoid ligament in his right ankle. It was, at the time, the worst injury Maddison had faced in his career. He did not start in club football again for almost three months.
Maddison worked hard to get his rhythm back in the second half of that season, but was not quite the same player. And that cost him a place in the England squad for the European Championship that summer.
Last season, Maddison started steadily, and with some thrillingly good moments.
He ran Manchester City ragged in Tottenham’s 4-0 win at the Etihad Stadium in November, scoring two early goals, and reminding everyone how hard to pick up he can be at his best. There were other minor injuries and knocks along the way — it was an exhausting season — but by the spring, Maddison looked back to his best. He was Spurs’ outstanding player as they overcame AZ and then Eintracht Frankfurt in the Europa League knockout rounds.
His ability to make late runs in behind the opposition defence, latching onto clever passes from the back, became Tottenham’s secret weapon. Postecoglou always said that Maddison needed to be 100 per cent fit for us to see his very best football, and this is what he was showing again. He had started seven out of eight games, his best run since 2023, until that first knee injury ended his season.
What makes the latest news so difficult for Spurs is that this is a terrible time to be losing a player like Maddison.
This is a squad in need of leadership and experience after the departure of Son to MLS side Los Angeles FC this week. Maddison was one of the vice-captains, and this injury puts Cristian Romero in pole position to take the armband long-term. But Maddison’s encouragement of younger team-mates, his direction on the pitch, and his willingness to speak to the media all make him an integral part of the group. After losing so much experience in recent years, Spurs need characters like him now more than ever.
Remember, too, that they are already without their other best creative midfielder. Dejan Kulusevski had knee surgery of his own on May 14 after an injury against Crystal Palace, a game he played largely in an attempt to get some rhythm back at the end of last season following a foot problem picked up in March that limited him to one start in two months.
With no Maddison or Kulusevski, there is a glaring lack of imagination and technical skill in the middle of the pitch. Who can be relied on to drive forwards through the middle, or change the tempo of the game, or play that final pass? We know from the past two years how much Maddison, at his best, can elevate Spurs. We also know how blunt and clumsy they can look when neither he nor Kulusevski is available.
If Tottenham had bought Morgan Gibbs-White from Nottingham Forest last month, this might be less of a crisis. But they did not, and Gibbs-White signed a new contract at Forest instead.
Now, with just over a week until the start of the new Premier League season, Spurs fans are left wondering how their team are going to create chances for the next few months. They have talented players in wide areas — especially with the arrival of Mohammed Kudus from West Ham this summer — but they need more through the middle, too.
They must find a solution in the market in the three-and-a-half weeks it remains open — or Frank’s debut season may struggle to get off the ground.
(Top photo: Chung Sung-Jun/Getty Images)