Sunderland defender Jordan Willis is facing up to an extra year on the sidelines after suffering a setback in his recovery from a knee injury.
He has now had a second operation that the club say could see him ruled out for "a further nine to 12 months".
They have extended his deal to cover next season.
Boss Lee Johnson told the club website: "First and foremost, we are here for Jordan on a human level - if he needs to reach out to anyone of us, we will help him as much as we possibly can.