Miller underwent exploratory surgery in Texas on Tuesday and an ACL injury was found in his right knee. He initially was placed on injured reserve last Thursday before the game against the New England Patriots, and it was decided last week that he would need a knee scope with the swelling going down and multiple opinions sought out, Bills general manager Brandon Beane said Wednesday.
The hope was that he would return this season. Miller said on his podcast last week that he hoped to return before this Sunday's game against the New York Jets.
But when Miller traveled to Dallas on Monday to have the knee looked at by Dr. Dan Cooper, the Cowboys' head team physician and a specialist in surgical techniques for knee and shoulder injuries, there was concern about the looseness of his knee.
"I knew Monday night that this was a real potential, you know, crossing our fingers," Beane said. "We were hopeful that it was a scope to clean the meniscus up and any scar tissue in there. But unfortunately, when [Dr. Cooper] went in there yesterday -- he did the surgery sometime yesterday afternoon -- when he went in there yesterday afternoon, he decided that it would not be stable enough, it would not hold up, and that a full repair was needed."
Miller suffered at minimum a partial tear to the ACL. Now attention turns to 2023 with Beane saying that "we think if everything goes well with rehab, we'll have him for most of 2023."
The Bills (9-3) currently have the top seed in the AFC with three games to come against the AFC East.
"Unfortunate situation, for Von, obviously, and our team. Care for him, obviously, like we would any player," McDermott said. "We know how much this means to him in terms of playing and being with the team, so we look forward to getting him back, obviously off the field for the rest of the season and his leadership, and we're certainly thinking about him as he recovers here."
Miller's absence for the Bills' run to the postseason will be a substantial loss. The Bills made the splash signing to have Miller, the Super Bowl 50 MVP, in the big moments and to help get the team closer to the Super Bowl. Now, they will face that challenge without him.
Miller suffered the injury on Thanksgiving at the end of the first half of the win against the Detroit Lions.
Miller, who signed with the Bills in the offseason on a six-year, $120 million contract, started every game this season except Thursday's and leads the team with eight sacks and 38 pressures.
"I'm good, man. I'll be right back," Miller said in a video posted to his social media accounts Wednesday. "Mentally, I couldn't be in a better spot, man, and I think that is the majority of it, man. Don't feel sorry for me. Don't say I hate it for you. None of that stuff cause I am good. I'm excited for the opportunity to show my teammates how tough I am, how hard I work and how important that this means to me."
In the team's first full game without Miller against the Patriots, the Bills pressured quarterback Mac Jones on 39.5% of his dropbacks -- the second-highest of rate of his career. The defense was able to have success against a struggling Patriots offense without blitzing. Defensive coordinator Leslie Frazier blitzed just once on Jones' last 28 dropbacks. Jones averaged 4.3 yards per attempt against four or fewer pass-rushers, his fewest in a game with at least 10 attempts.
"Listen, you care about every player, right, and it affects you when guys go down," McDermott said. "It's the business we're in, it's a physical game, and so we care for everyone. Certainly, we care for Von in this case, and we'll miss him. But as I said last week when he was out, it's a time and an opportunity for other guys to step up."
Defensive end Greg Rousseau especially stepped up with a team-high five pressures. The Bills have used a first-round pick (Rousseau) and two second-round picks (AJ Epenesa and Boogie Basham) at the position in the past three seasons. The team will need those players to step up.
The Bills have now lost two key defenders to season-ending ACL injuries in Thanksgiving games in back-to-back years. Cornerback Tre'Davious White is coming off playing in his most complete game since tearing his ACL in New Orleans last season. White returned to the field for the first time since the injury in the game against the Lions.
"It's tough when you lose a really good player like Von, you know, but we got a lot of guys in the room and we all just need to step up," Rousseau said. "We're all ready for the opportunity to step up. It's unfortunate, but I know I'll be praying for Von and I'm wishing him a speedy recovery cause that's our guy. We love Von, he's a brother to us, so it's sad to see him, see that he's not gonna be out there no more, but it's like, we got to step up, there's no time for us to feel sorry for ourselves or none of that."