"Busy treatment room" - Five England stars will miss the 2024 Six Nations through injury

But for some of England's biggest stars their 2024 Six Nations dream could soon turn into a nightmare, with injury threatening their participation in this international rugby showpiece.

The 25-year-old flanker's condition, which has deteriorated since England's Rugby World Cup triumph over Argentina, necessitates surgery and an extended recovery period, ruling him out for the rest of the season and the upcoming Six Nations tournament.

“This is the only option,” Sale director of rugby Alex Sanderson said. “Tom has been back down to London to have further extensive X-rays under movement with a different consultant and this is the best thing for him in the short term.

“I know it sounds long-term - the season - but it’s not. He’s still a young lad and it’s the best thing for him in the short term to ensure he’s able to be more robust moving forward and to train and progress his game the way he wants to.

“He has just got some wear and tear issues around his socket and a little bone that needs shaving off and cleaning up.

“My understanding is there are three procedures you can have on your hip of this nature. One is this, which is the least invasive. Then you can have a metal resurfacing and then you can have a hip replacement, so I guess this is the better of lesser evils.”

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The Scotland-born prop is out for the rest of this season after undergoing surgery on a fractured toe.

The 32-year-old midfielder, who sustained a grade three tear during Sale's win over Saracens, faces a six-week rehabilitation period but thankfully avoids the need for surgery.

With a notable presence in England's recent World Cup campaign, Tuilagi will be sidelined for the opening Six Nations fixture against Italy in Rome on February 3.

"Manu has pulled his groin and we think he's going to be back during the Six Nations, but not for the first week," said Alex Sanderson, Sale director of rugby.

"I spoke to him and he's like 'I need to play and if I'm good to play it's up to England regarding selection'

"He was in the frame before and I've stated before his intent to keep playing international rugby. Six weeks is the recommended time for the injury and Manu is saying four."

Marler’s fellow loosehead props Ellis Genge, Bevan Rodd, and Val Rapava-Ruskin are also on the sidelines.

On the 88-cap Marler, who was hurt during Quins’ victory over Gloucester 10 days ago, the club’s head coach Danny Wilson said: “There is still a little bit of assessment going on.

“Joe is a week-by-week process at the moment to make a full assessment of the time period and the time-frame.

“He is not going to play this weekend – that is pretty clear – but what I can’t give is a time-frame. There have been a few twists and turns with it.

“We are kind of in the middle of a full assessment.

“I know that is going to sound a little bit like it is taking a while to assess, but there is a little bit to this one so I am probably not really going to be able to give you much.

“Until we get a full picture and a full time-frame, and we are in that process at the moment, then I can’t really tell you a huge amount.”

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The free-scoring wing is out until March with a foot injury.

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Seeing as we’re nice people, we’ve given you 30 minutes to see, with the number of appearances each nation has made given as a clue.