London - England wing Jonny May looks likely to miss the whole of his country's Six Nations campaign with a knee injury.
May was forced to come off during Gloucester's English Premiership draw against Harlequins at Twickenham last weekend.
He sustained the injury while kicking the ball and it has now emerged that he needs surgery.
"Jonny has suffered a pretty significant knee injury that requires surgery," Gloucester director of rugby David Humphreys told the Gloucester Citizen on Thursday.
"He's seeing a specialist on Tuesday and based on the outcome of that we will have a much clearer picture on what needs to be done.
"Most importantly, it is a huge blow for Jonny to suffer an injury like that at this stage of the season. But knowing him and his dedication, he will leave no stone unturned in his recovery."
England's first Six Nations fixture is against Scotland on February 6 and given Humphreys' bleak prognosis it seems highly unlikely that May will play any part in the tournament.
The 25-year-old had re-established himself as England's first choice wing in the second half of this year.
His absence would be another blow to new England head coach Eddie Jones, who has already lost centre Henry Slade, back row Dave Ewers and prop Kieran Brookes to injury for all, or part, of the Six Nations.