Italian lock Marco Lazzaroni will miss the remainder of the Six Nations in order to have an operation on his left arm, the Italian rugby federation announced on Monday.
Lazzaroni, who has 15 caps, came on as a second-half replacement in the defeat by Wales on Saturday but only lasted 11 minutes before having to leave the field.
The federation said he had suffered a detached tendon in the biceps of his left arm and will undergo surgery in Rome on Tuesday.
The federation gave no indication of how long the Treviso forward will be out of action but added uncapped second row Riccardo Favretto and Andrea Zambonin to Franco Smith's squad.
Zebre's 24-year-old winger Pierro Bruno will also join the set-up this week.
Italy have lost all four matches so far, conceding 187 points and 26 tries in the process.
They need to win their final match against Scotland on Saturday to have any hope of avoiding a sixth successive wooden spoon.