Everton defender Phil Jagielka has had a second knee operation and may not play again until after Christmas.
The 27-year-old has been out since damaging knee ligaments against Manchester City in April but was hoping to return before the end of November.
But boss David Moyes said: "Jagielka had an operation on a tear in his meniscus, the cartilage in his knee.
"We think it has set him back four to six weeks. He was down initially but he's on the road to recovery now."
Former Sheffield United defender Jagielka made his first England start in February in the 2-0 friendly defeat in Spain.
He also scored the winning penalty against Manchester United, which booked Everton's place in last year's FA Cup final.
Moyes added: "It's disappointing as Phil was due to start light non-contact training this week.
"It was just part of his rehabilitation. When you get your cruciate done, it nearly always damages the cartilage.
"Most people who now have their cruciates done, it does sort of rip the cartilage. Joe Cole had the same thing and that's what has happened with Jags.
"But even if Jags comes back in six weeks that's still a pretty good recovery as it's usually seven to seven-and-a-half months after a cruciate.
"At the moment it's six months, which is a bit sharpish to return. If Jags is seven months then its not outrageous, it's just a little setback."
Moyes also confirmed that striker Victor Anichebe has also suffered a complication in his recovery from a knee injury.
Anichebe, 21, has not played since February and appears some way off a return to the first team.
Moyes said: "Victor's not in a good way. He had the pin taken out four to six weeks ago which had been catching on the side of his knee.
"Now what has happened (is that) he has a massive growth of bone and has a really big knee at the moment."
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