Josh Lewsey will miss his first England match since the 2003 World Cup after being ruled out of Saturday's Six Nations Champion-ship clash with Italy.
The Wasps full-back, an ever-present under head coach Andy Robinson, damaged his left shoulder in the first minute of England's 47-13 victory over Wales at Twickenham last Saturday.
Lewsey soldiered on for 20 minutes but conceded defeat when he could no longer lift his arm. The England camp was relieved that a scan on his ACL joint - which connects the collarbone to the shoulder - showed no evidence of structural damage.
Leicester winger Tom Varndell, fresh from scoring four tries for England A last weekend, has been drafted into the 31-man squad as Lewsey's replacement.
Bristol scrum-half Shaun Perry has also been called up, in place of Gloucester's Peter Richards who also has a shoulder injury.
Winger Mark Cueto suffered bruising to his lower back but is available to Robinson, who this afternoon names his side to play Italy.
Tom Voyce, Lewsey's Wasps colleague, impressed Robinson with a try-scoring performance off the bench on Saturday and could make his first Six Nations start.
But England are unlikely to make many other changes after Italy gave Ireland quite a scare at Lansdowne Road.
The loss of Lewsey, who could be out for at least a fortnight, leaves England short of cover in the centre, possibly opening the door for Stuart Abbott to win a place on the bench. Otherwise, Robinson wants to keep his side together after a performance that Lewsey described as England's best since the World Cup.
Robinson said: "Apart from Josh's injury, I'm not going to make any changes."
