Leicester Tigers hooker Tom Youngs will miss England's autumn internationals after being ruled out for three months with a shoulder injury, reports BBC Radio Leicester.
Youngs was injured in Saturday's 45-0 defeat away at Bath in the Premiership.
The 27-year-old will miss England's games with New Zealand, South Africa, Australia and Samoa in November.
|England 2014 autumn international dates|
|8 November: England v New Zealand|
|15 November: England v South Africa|
|22 November: England v Samoa|
|29 November: England v Australia|
"He had surgery on Monday and it will probably be three months," said Tigers director of rugby Richard Cockerill.
It is a further blow to England, who are already without two other frontline front-rowers in Tigers tight-head Dan Cole (neck) and Saracens loose-head Mako Vunipola (knee) for the November series.
Youngs, who has won 17 caps, made his international debut against Fiji in November 2012.
He was part of England's 23-man match-day squad throughout the 2014 Six Nations, but missed the summer tour of New Zealand for family reasons.
Northampton hooker Dylan Hartley has been England's first-choice hooker this year, while Bath's Rob Webber was the back-up number two in Youngs' absence against the All Blacks this summer, and started the first Test in June as Hartley arrived on tour late following the Saints' victory in the Premiership final.
Norfolk-born Youngs, the brother of England and Leicester scrum-half Ben, began his career as a centre and only started his first game at hooker for Nottingham against Cornish Pirates in September 2009.
Youngs also made three appearances for the British and Irish Lions on the 2013 tour to Australia.