Bath prop Matt Stevens has undergone a second shoulder operation that will rule him out of England's autumn Tests.
Stevens has won 10 caps for England since June 2004
It is the latest setback for the 23-year-old, who missed England's summer tour to Australia after an initial operation in April.
But his right shoulder failed to respond as quickly as anticipated, leading to more surgery on Monday to repair his rotator cuff tendon.
Stevens needs six weeks' recuperation before beginning his rehabilitation.
But Bath do not anticipate he will be available for England's four November internationals against New Zealand, Argentina and South Africa (two).
England's paucity of propping resources saw 35-year-old Leicester loose-head Graham Rowntree recalled for the Australia tour, with Andrew Sheridan and long-term victim Phil Vickery also sidelined through injury.