Italy captain Sergio Parisse has declared himself unfit for the opening World Cup clash against France at Twickenham, the Italian management announced on Saturday.
The 31-year-old Argentine-born No 8, capped 112 times by Italy and their star player, has not fully recovered after undergoing surgery to drain a haematoma last Monday.
He picked up the injury, a swelling of clotted blood, in a muscle in his left leg in Italy's World Cup warm-up defeat to Wales in Cardiff last weekend.
The federation initially said Parisse would not meet up with the Italy team in Rome on Saturday but will instead link up "at a later date" in England.
Manager Jacques Brunel said he was hoping Parisse would be fit for Italy's second game, against Canada the following Saturday.
After the Group D curtain-raiser against the French Italy face Ireland, Canada and Romania.