The start of Hargreaves' second season at United was hampered by injury, a recurring patellar tendinitis problem that restricted him to sporadic appearances in 2008–09. After trips to specialists in both London and Sweden yielded no results, Hargreaves travelled to Colorado, USA, in November 2008 to visit renowned knee surgeon, Richard Steadman. Hargreaves underwent surgery on his right knee on 10 November 2008 and received a similar operation on his left knee in January 2009. However, this meant that Hargreaves would miss the remainder of the 2008–09 season, ultimately meaning he would miss out on a second Premier League title as well as League Cup, FIFA Club World Cup and FA Community Shield winner's medals. Hargreaves underwent his rehabilitation programme in the United States, and was due to return to training with Manchester United at the Audi Cup in Munich. However, upon assessment, it was decided that he should continue with his rehabilitation in the United States. Hargreaves returned to Manchester United on 23 September 2009, joined by his physiotherapist for a week to aid the transition process and for the club to understand his rehabilitation programme.