James Maddison has suffered another injury setback in a gut-wrenching blow for the Tottenham midfielder.

Maddison, who missed nearly the entirety of last season with an ACL tear, was forced off in Spurs’ London derby with Chelsea on Saturday afternoon.

He went down soon after the second half got underway at Stamford Bridge, crouching and looking to the bench before hitting the deck as his team-mates signalled team doctors onto the pitch.

Maddison walked off the pitch visibly dejected and was replaced by former Chelsea midfielder Conor Gallagher, who was booed as he entered play.

He went straight down the tunnel after being substituted, receiving a pat on the back from opposition manager Xabi Alonso.

James Maddison went straight down the tunnel after being replaced (PA)

Maddison has had his entire Tottenham career plagued by fitness issues and only made his first start since May 2025 against Coventry , when the midfielder scored and starred in a 3-1 win - the club’s first of the season.

He missed 24…