Saracens hooker Jamie George will miss England's autumn internationals after being sidelined by injury.
A club statement said: "It is expected that he will be out for around 10 weeks, returning in early December."
England host Argentina in their opening autumn international at Twickenham on 6 November.
Eddie Jones' side will then entertain Japan, New Zealand and world champions South Africa on the following three weekends.
George made his first start for England in November 2017 and has won 69 caps.
He was one of three players to withdraw from a three-day England training camp in London along with Leicester centre Guy Porter and Harlequins' Jack Walker.
Newcastle duo George McGuigan and Adam Radwan, and Gloucester's Jack Singleton have been called up as replacements.
England already had a long injury list before these latest withdrawals, with the likes of Saracens lock Maro Itoje, Harlequins number eight Alex Dombrandt, and Leicester wing Anthony Watson all currently sidelined.