Tottenham have been dealt a major blow - James Maddison has been ruled out for most of the season following a severe ACL injury that will sideline him for over six months.

The 28-year-old was stretchered off during Spurs' pre-season clash with Newcastle in South Korea last weekend after aggravating the same knee issue that ruled him out of the Europa League final in May.

The setback couldn't have come at a worse time for both player and club. With the start of the Premier League season just days away and Champions League football - a competition Maddison was preparing to debut in - on the horizon, the injury has left manager Thomas Frank and the Spurs hierarchy scrambling for solutions.

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Maddison's injury not only removes their key playmaker but forces a rethink of the team's attacking blueprint. With just a few weeks left in the transfer window, Spurs are expected to actively pursue suitable replacements. Here, football.london runs through the most likely candidates.

Eberechi Eze has long been on Tottenham's radar, and Maddison's setback may now accelerate their interest. The Crystal Palace star's creativity, versatility, and goal threat make him an ideal candidate to step into Maddison's shoes - particularly after a campaign where he notched 14 goals and 11 assists, including the decisive goal in the FA Cup final.

Palace are demanding his £68million release clause be paid in full, and with urgency mounting, Spurs may be prepared to pay up. The departure of Heung-min Son to LAFC earlier this week has only deepened the attacking gap in Frank's team - and Eze could be the ideal candidate to help plug it.

His mix of athleticism and refined technique, alongside proven top-flight credentials, makes him a prime target. However, Tottenham could face stiff competition, with Arsenal mulling over an approach too.

Jacob Ramsey offers a more energetic, box-to-box presence. The 24-year-old's drive and ability to transition from deep areas could suit Spurs' system well, but his modest goal return - just one in the Premier League last season - may raise concerns.

Aston Villa have put a £40m valuation on him, though financial pressures at the club might make negotiations more flexible in the weeks ahead. Tottenham have tracked Ramsey for some time, intrigued by his defensive work rate and tactical intelligence.

While he doesn't replicate Maddison's flair or productivity in the final third, his age, homegrown status, and high-tempo approach make him a compelling option for a team aiming to balance future growth with present needs.

Harvey Elliott was once considered a central figure in Liverpool's next generation, but his progression has slowed. Having made just two league starts under Arne Slot last season, his long-term role at Anfield appears uncertain.

Although RB Leipzig have shown interest, Tottenham might step in to provide a domestic lifeline - and a clearer route to first-team minutes. At 22, Elliott still offers significant developmental upside, with his vision, adaptability, and European experience making him an appealing option.

That said, Liverpool are unlikely to let him leave cheaply. They're reportedly asking for £40m, with a potential £50m price tag if no buy-back clause is included.

Despite the cost, Spurs may see him as a worthwhile risk. His football IQ, determination, and positional flexibility - traits once prized by Jurgen Klopp - could make him an asset both immediately and for seasons to come.