During the 2009 Ashes series in England the focus, every match, was on Andrew Flintoff's disintegrating knee. He was patched up to perform heroics at Lord's, but that was his last great stand and he limped his way across the line at The Oval although not without one final piece of showmanship to run out Ricky Ponting.

This time another part of another bowlers' anatomy will be the focus of attention. The decision to send Graeme Swann for elbow surgery in the United States is an admittance that the joint has almost reached breaking point. As with many bowlers, Swann has rarely operated pain free but every effort had been put in to manage and nurse him through to January 2014 and the Sydney Test.

It is a mark of how successful that strategy has been that this was the first time Swann had to concede his Test place through injury. The other matches he had missed since his debut against India in late 2008 - two in West Indies on the 2009 tour and last year's Headingley Test against South Africa - were tactical decisions.

But the point of no return had been reached. The operation could not be left any closer to the start of the Ashes on July 10 at Trent Bridge. Recovery timescales rarely go exactly to plan. The positive spin, fitting perhaps for one of England's most positive spinners, is that the Champions Trophy remains in sight for Swann. The man himself, ever the optimist, is hoping for May.

Swann has not even gone under the knife yet and only then will a clearer comeback target be known, although following his previous surgery, after the Tests in the Caribbean in 2009, he was back playing two months later for the May Tests.

Providing the operation is a success, Swann will need first-class matches to show he is able to withstand Test cricket. England play Essex from June 30 as Ashes preparation (as they did against Warwickshire in 2009) but if Swann takes part in the Champions Trophy it would rule him out of County Championship action for Nottinghamshire. Retirement from limited-overs cricket may yet have to be contemplated.

Unless he is back bowling by early May it is hard to see how he would have enough workload to properly test the elbow. He got through the one-dayers in New Zealand; it was only when he bowled longer spells in Queenstown (where he sent down 42 overs) that his elbow problem flared up again.

"Swann remains head-and-shoulders above any of Australia's current spinners but Monty Panesar is also better than Nathan Lyon, Xavier Doherty and Glenn Maxwell"

There is, of course, also the worst case scenario that the operation won't work. This is a different operation than the one Tim Bresnan has recently undergone, which was to remove scar tissue and from which the outcome is more certain. The last time, in 2009, before that year's Ashes series, Swann's surgeon said he couldn't get to the last two pieces of bone as they were too close the nerve. Even in this day of modern surgical skills, sometimes there is not the perfect outcome.

That, however, would not need to be terminal to England's Ashes hopes. It did not take long for Australians to latch on to the news of Swann's withdrawal from the New Zealand tour. With their current problems in India it was being suggested that finally some good news had emerged for them.

Swann remains head-and-shoulders above any of Australia's current spinners but his No. 2, Monty Panesar, is also better than Nathan Lyon, Xavier Doherty and Glenn Maxwell. Just look at their returns in India compared to what Panesar managed late last year. In one-day cricket over the last few months James Tredwell, who is now flying to New Zealand, has also shown himself a very reliable bowler. Swann's returns in the ODIs on this tour were not as impressive as Tredwell's in India.

It is far from ideal that Panesar is entering this Test having not bowled a competitive delivery since the Nagpur Test, but he is a more confident person these days. He is not the fully rounded Test bowler that Swann has become - or the all-round cricketer who can offer runs and slip catching - but it is unfair to pigeonhole him as a spinner who can only do a role overseas. Swann, for all his craft and skill, has averaged 40.05 in his last 12 home Test matches and if you remove three Tests against Sri Lanka that goes up to 48.65 in nine matches.

The decision to try and get Swann sorted now, rather than patch him up again in the hope everything works out okay, only to see him ruled out shortly before the Ashes, means Panesar has time to get his mind around the possibility of being England's main spinner for the summer. It may not come to that. Everyone will hope for the best, but it would be prudent to plan for the worst.