United States centre-back Miles Robinson is a major doubt for the World Cup after rupturing the Achilles tendon in his left leg.
The 25-year-old sustained the non-contact injury in the 14th minute of Atlanta United's 4-1 MLS win over Chicago Fire on Saturday.
Robinson, who has been capped 21 times by USA, slammed the turf in frustration and was stretchered off.
Atlanta confirmed on Monday that the defender will undergo surgery to rectify the damage.
While no timeframe has been given for Robinson's return, he is not likely to play again before Qatar 2022, which runs from November 21 until December 18.
He had become a regular for USA alongside Walker Zimmerman in their World Cup qualifying campaign, but coach Gregg Berhalter may now be forced to rethink his plans.
Berhalter's side have been drawn in a group alongside England, Iran and one of Scotland, Ukraine or Wales.