England head coach Stuart Lancaster will have to plan with Courtney Lawes and Tom Croft for the tour of South Africa this summer.
Lancaster has confirmed Lawes and Croft are among six players unfit to travel with the Red Roses for the tour of South Africa with Joe Simpson, Tom Wood, Charlie Sharples and Rob Webber unavailable through injury.
Croft was a key member of England's Six Nations squad but he sustained a neck injury during Leciester's game against Harlequins last month and he will have to undergo surgery, which will see him sidelined for between four and six months.
Lawes, meanwhile, continues to be troubled by a shin injury and Lancaster will not risk his fitness by including him in the squad for South Africa.
The injury to Simpson could result in Danny Care making his return to the squad. Care was omitted from the Six Nations squad due to off-field matters but he is back in the running for a place and he could battle with Lee Dickson and Ben Youngs for the half-back berth.