Defender John O'Shea is a major doubt for the Republic of Ireland's Euro 2012 play-off against Estonia.
Sunderland manager Steve Bruce has already ruled O'Shea out of Saturday's Premier League trip to former club Manchester United, and revealed his chances of making the first leg of Ireland's showdown with the Estonians in Tallinn a week on Friday are remote.
That will come as a huge blow to Republic manager Giovanni Trapattoni, who has installed the versatile defender as a cornerstone in his rearguard.
Bruce said: "It's not that bad. We think it's a normal grade one. He's certainly got no chance for Saturday, and looking at the first game for Ireland next Friday, I would have thought he's a huge doubt for that as well, which is a shame for the lad.
"It's typical of the luck he's had, unfortunately, since he's been here. They are probably the two biggest games he has been looking forward to.
"He might have a chance for the second one, but certainly I would have thought the first game would come a little bit too quickly for him.''
West Brom striker Shane Long looks sure to be out too despite being named in the squad for the qualifying decider.
Baggies assistant boss Michael Appleton claimed he would be "very surprised'' if Long has recovered from his knee injury in time for international duty.
Albion predicted Long would be sidelined for six weeks when he suffered the setback 12 days ago against Aston Villa in a challenge from Alan Hutton.
Appleton said: "It is one of those injuries you really have to be cautious with. Shane is doing everything the physios are asking him to do. He is working hard on the bikes but has not done any impact stuff.
"I have seen players come back from injuries ahead of when they are expected to. But I would be very surprised if Shane is available for the Ireland game. He will have to make a massive recovery in the next week or so.''
As a result, Newcastle striker Leon Best has been called into the squad. Best has been in superb form for the Magpies, and his partnership with Demba Ba has been a key feature of the club's rise to third place in the Premier League table.
A statement released by the Football Association of Ireland said: ''The Football Association of Ireland today confirmed that Newcastle striker Leon Best has been called up into Giovanni Trapattoni's squad to face Estonia in the Euro 2012 play-offs on November 11 in A le Coq Arena, Tallinn, and November 15 in Aviva Stadium, Dublin.''
The first leg of the play-off is in Tallinn on November 11 with the return in Dublin four days later.