Jonny Wilkinson is to undergo shoulder surgery which will rule him out of England's Six Nations campaign.
Wilkinson has only played one game since the World Cup
The Newcastle stand-off will have the operation on his right shoulder on Wednesday, and is expected to need six to eight weeks to recover.
That means Wilkinson is unlikely to play any part in the Six Nations, with the last game in France on 27 March.
It is the latest blow to England's hopes of defending their Grand Slam, with five other players out of action.
Coach Sir Clive Woodward is already without Mike Tindall, Charlie Hodgson, Julian White, Lewis Moody and Stuart Abbott for the opening game in Italy next Sunday.
Wilkinson saw a specialist on Friday, who recommended surgery to clear up a problem that has dogged him since the World Cup.
He has played just 53 minutes of rugby since his winning drop goal secured victory against Australia on 22 November.
With Wilkinson out of contention and Hodgson also injured, Paul Grayson, Alex King and Olly Barkley will compete for the number 10 jersey.
Wilkinson has maintained his fitness levels during his absence, but admitted on Thursday that his failure to shake off the shoulder problem was getting him down.
"I have been training very hard for each game during the week and then having to deal with the disappointment in quite an intense way when coming up to the weekend that I was not going to make it," he said.
Wilkinson's half-back partner Matt Dawson believes England have sufficient cover to cope with the absence of their World Cup hero.
"If it means Jonny comes back fitter and stronger and able to play for England for many years to come, then let's get it done and move on," he told BBC Radio Five Live.
"We are in a very fortunate position. Jonny has set such high standards that everybody - especially the fly-halves - realise what level they have got to be at if they want to compete with him.
"Paul Grayson is very experienced, Alex King has played a few games for England before and Olly Barkley is having the season of his life.
"I think the cover is there and they will do a great job in the Six Nations."