Why is James reluctant to undergo knee surgery? His friend Mardy Fish had his knee operated as well as Serena Williams. It is still a better option for him than playing in pain.
From what I heard he is a really big health nut and does not believe in surgery especially at this point in his career. He also does not take any antiinflammatories because he does not like the side effects. I think he lacks the motivation and the drive it takes to come back from a surgery. James seems to have given up on his career and has hinted that this summer will be his last.