West Ham United midfielder Mark Noble will miss the England Under-21 qualifiers against Bulgaria and Portugal as he will undergo a double hernia operation.
Noble has scored in two of England's wins as Stuart Pearce's youngsters have started their Euro 2009 campaign with a 100% record as he has travelled to Germany to see Dr Ulrike Muschaweck, who has also treated Michael Owen and Craig Bellamy.
Martin Cranie fractured his fibula while on loan at QPR and misses out but Craig Gardner can play at full-back.
Michael Johnson missed the wins over Montenegro and Republic of Ireland and is out again with his groin complaint.
Sunderland's Grant Leadbitter has earned a call-up, while James Vaughan is back in the squad after recovering from a dislocated shoulder.
'Grant's played in one or two positions for Sunderland this season and has done very well,' Pearce said.
'I went into Sunderland a couple of weeks ago and watched them train, and also saw him play against Manchester City.
'He's playing regularly and getting Premier League experience and I think he deserves his chance in the squad.'
England will face Bulgaria at stadium:mk on November 16 and travel to Portugal the following Tuesday, by which time they could have virtually secured a place in the play-offs to reach the finals in Sweden.
Pearce added: 'We've got some absentees with Mark Noble, Michael Johnson and Martin Cranie all out, but have been able to bring in some new players who have been looking good this season.
'It's the first time back in for James Vaughan since the summer and he's been very unlucky with injuries otherwise he would have been in the other squads this season.
'But it's good to see him back in contention, especially after a goal for Everton on Saturday.'
England Under-21 squad:
Alnwick (Tottenham), Hart (Man City), Heaton (Man Utd); A Taylor (Middlesbrough), Onouha (Man City), S Taylor (Newcastle), Wheater (Middlesbrough), Gardner (Aston Villa), Mancienne (Chelsea), Jones (Preston); Huddlestone (Tottenham), Johnson (Middlesbrough), Kightly (Wolves), Milner (Newcastle), Muamba (Birmingham), Surman (Southampton), Walcott (Arsenal), Cattermole (Middlesbrough), Leadbitter (Sunderland); Agbonlahor (Aston Villa), Derbyshire (Blackburn), Moore (Aston Villa), Jerome (Birmingham), Vaughan (Everton).