By Nick Wagoner

Senior Writer

Almost a year removed from a season-ending ACL injury, guard Mark Setterstrom suffered another serious health setback Saturday night against the Chargers.

Setterstrom’s injury is being called a sprained left knee though coach Scott Linehan said it looks like a fractured patella. He was carted off the field with about 11 minutes to go in the third quarter.

“That looks like something that will be season ending,” Linehan said. “They still have to look at it. It couldn’t have been good. I know he was in extreme pain.”

Setterstrom began the 2007 season as the team’s starter at left guard but suffered a torn left ACL that cost him 13 games.

Setterstrom suffered that injury on then kicker Jeff Wilkins’ 25-yard field goal when his knee was rolled up awkwardly between two other players.

The injury was severe enough that Setterstrom had to be taken off on a cart and did not return to the field.

The similarities between that injury and the one Saturday night were eerily similar. Setterstrom received a warm ovation from the fans as he was carted off waving, much like inTampa Bay .

Although the extent of the injury is unknown, it didn’t appear to be such that Setterstrom will be back right away.

Setterstrom had been shuttling between guard and center for most of this offseason but was working exclusively at guard since coming back from some tightness in the muscle around his knee during camp.

GREEN’S SHORT NIGHT: Near the end of the first half, quarterback Marc Bulger was sacked by Jyles Tucker and fell awkwardly on his shoulder.

“He’s OK,” Linehan said. “He got his arm caught but they checked his shoulder and by the second half it was fine. It wasn’t a big one.”

The injury didn’t appear serious but the Rams removed Bulger for precautionary purposes. Trent Green, who wasn’t scheduled to play against the Chargers came into the game.

Green quickly completed a 19-yard strike to tight end Randy McMichael and another one for 16 yards to set up a field goal attempt at the end of the half.

OTHER INJURIES: In addition to Setterstrom and Bulger, the Rams had a couple of other injuries of note.

Running back Brian Leonard suffered a left shoulder strain and rookie linebacker David Vobora had a left ankle injury.

Fullback Russ Weil also suffered an ankle injury and did not return.

INACTIVES: The Rams were without five starters against the Chargers.

Torry Holt (back spasms) sat out and was replaced by Dante Hall. Nick Leckey replaced Brett Romberg (hand) at center and Antonio Pittman started for Steven Jackson at running back.

On defense, the Rams went with Ron Bartell at cornerback in place of Fakhir Brown (shoulder) and Todd Johnson was in for Oshiomogho Atogwe (hamstring).

San Diego played without 14 starters including superstars such as running back LaDainian Tomlinson, tight end Antonio Gates and linebacker Shawne Merriman.

RAM BITS: The announced attendance for the game was 53,039…Left tackle Orlando Pace played the entire first half, the most reps he’s received in a game since the 2006 season…Bruce Gradkowski got the second quarterback opportunity after the starters ended their half.