England captain Andrew Flintoff has been ruled out for some 12 weeks after being told on Saturday that he needs surgery on his injured left ankle, the England and Wales Cricket Board (ECB) announced.
The all-rounder will have the operation next week and will miss the three remaining Test matches against Pakistan and the five subsequent one-day internationals against Inzamam-ul-Haq's side. He must also be a major doubt for the Champions Trophy in India, which starts on October 7, one week before the end of Flintoff's scheduled rehabilitation period.
And with the first Test against Australia starting in Brisbane on November 23, there are bound to be question marks against Flintoff, the star of last year's Ashes where he scored 402 runs and took 24 wickets, being fit in time for the series England prize above all others.
The negative results of Flintoff's consultation with a specialist were made public 24 hours before England are due to announce their squad for the second Test. The match starts on Thursday at Old Trafford, Flintoff's home ground.
The ankle problems had already forced Flintoff to sit out a five-match one-day series against Sri Lanka, which England lost 5-0, and the first Test against Pakistan, which ended in a draw. But he had appeared on track for a comeback at Old Trafford after playing without pain for the first three days of his county Lancashire's match at Kent.
On Friday however he began to feel discomfort in the ankle after bowling just two overs, prompting the England and Wales Cricket Board (ECB) to send him back to the specialist.
The injury first became apparent when Flintoff was bowling during the final Test against Sri Lanka at Trent Bridge nearly two months ago. A scan revealed floating bone fragments, left over from an operation on the same ankle at the beginning of last year.
Flintoff was badly missed during the embarrassing one-day whitewash by Sri Lanka and his absence meant England had just four frontline bowlers on show at Lord's, where they lacked the firepower to bowl Pakistan out twice on a good pitch.
The absence of Flintoff makes it likely Warwickshire batsman Ian Bell, who was set to be axed despite scoring an unbeaten hundred at Lord's, will retain his place in the second Test line-up and Andrew Strauss will continue as captain.
Flintoff, 28, is the second captain England have lost this season after Ashes-winning skipper Michael Vaughan suffered a recurrence of his longstanding knee problem which saw the Yorkshire batsman ruled out of the return Test series against Australia. In both cases, comebacks were attempted only for each man to then be told they required an operations which could have been carried out earlier - a point which is likely to leave England's medical staff facing some awkward questions about the way they've looked after the team's two leading players.