American midfielder Stuart Holden has suffered a major setback after returning from a long-term knee injury and will miss another six months, according to his English Premier League club, Bolton Wanderers.

“It is a big, big blow for Stuart because he has worked so hard after he sustained the injury, but obviously the most important aspect is to ensure Stuart’s well being and that’s what we are focused on,” Manager Owen Coyle said on the club’s Web site. “He went in for the procedure this afternoon and it was picked up that the cartilage was damaged and needed to be repaired, which has now happened, and we will now support Stuart as he begins his recovery.”

Initially injured against Manchester United in March, Holden returned to first-team duty last week against Aston Villa.

This morning, both Holden and the club said he would miss six weeks, not six months. But following the procedure, a new timetable was set. He should be fit in time for the start of U.S. World Cup qualifying in June, but with only a few weeks of competitive matches, his fitness and form would become a factor.

On his Twitter account, Holden wrote: “Floored, devastated, gutted, just a few words I can think of. I will continue to fight and I’m ready for another tough journey. Not looking 4 sympathy but rather your support as I get through another setback. I look forward to keeping you updated over the next 6 months as I beat the odds once again.”

(Post colleague Paul Tenorio chronicled Holden’s comeback in July.)