West Ham will decide in the coming days whether striker Craig Bellamy requires a second operation on his persistent abdominal injury.
Bellamy has already spent six weeks on the sidelines after the original surgery, which he underwent in Germany in October, failed to cure the problem.
West Ham's medics have been working to find a solution but are beginning to fear more surgery may be the only answer.
And that would almost certainly rule Bellamy out of the club's hectic Christmas schedule, with a run of eight games in a month starting with tomorrow night's Carling Cup quarter-final against Everton.
Over the next four weeks, West Ham also face Manchester City in the third round of the FA Cup and six Premier League fixtures including Manchester United and Arsenal.
West Ham manager Alan Curbishley said: 'We have to decide this week where we are going to go with Craig.
'We have to decide whether to continue with the route we are going down which, if it is successful, will result in a shorter route.
'We may have to go down the surgery route which will be a longer one. If that is the case I can't put a time-frame on it.'
West Ham believe the problem stemmed from the foot supports Bellamy inserted into his boots during pre-season.
The problem first flared up in West Ham's Carling Cup win over Bristol Rovers in August.
Bellamy has made just eight starts since his club record £7.5million move to Upton Park from Liverpool in the summer.