Career-threatening knee surgery may again loom for Matt Bowen - but the livewire fullback is still hopeful of playing out the rest of the NRL season for the Cowboys.

North Queensland team manager Dean Lance confirmed Bowen's right knee may require the same radical procedure successfully completed on his left one in 2008.

Surprisingly, that is not the immediate concern for Bowen ahead of Friday night's make-or-break clash with the resurgent Broncos at Townsville.

While Bowen has been able to soldier on despite degenerating cartilage in his right knee, an aggravated left knee strain suffered in last round's loss at Newcastle may force him to miss the remaining two games of the regular season.

The Cowboys are already reeling from news that Ash Graham is set to miss the rest of the season after aggravating the foot complaint that had earlier sidelined him for eight weeks.

Medical staff have opted to assess Bowen's right knee in the post-season and determine whether he will require the same procedure he underwent on the left knee in 2008.

The radical procedure involves growing cartilage before having it inserted in the knee and is "not without risks".

Cowboys medical staff believe a successful operation could extend Bowen's career but he would be sidelined until next July at the earliest.

In the meantime, they will monitor Bowen's left knee and determine whether to give him the green light for a Broncos clash they must win to keep their faint finals hopes alive.

"We are still hopeful that he can play the remaining games we have left," Lance told AAP on Monday.

"The physio is telling us they will have a look at it (right knee) at the end of the season.

"It (radical surgery) is worse case scenario (but) it seems to be the case.

"However, we will only know more when they go in and have a look and learn what damage has been done.

"I am not ruling anything out. It might be better news than that."

Lance said Bowen had already steeled himself for the long recovery that he endured in 2008.

The left knee went under the knife after round eight last year and he was sidelined for 10 months.

"We all get a bit downhearted with form and injuries but Matt is one of the most positive blokes around, he keeps his chin up," Lance said.

Bowen aggravated a left knee strain suffered the previous week and was eventually taken off in the 52nd minute as the Cowboys - who at one stage led 22-8 - crashed 32-26 to the Knights at Newcastle last Saturday night.

North Queensland must win their final two regular season games and rely on other results to scrape into the finals.

"We've just got to aim up. Our destiny is the hands of the gods if you will," Lance said.

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