United States midfielder Catarina Macario on Tuesday became the latest star to rule herself out of the Women's World Cup after a knee injury.
The Brazil-born 23-year-old has missed the past year after rupturing an anterior cruciate ligament while playing for French side Lyon.
US coach Vlatko Andonovski had been hoping that Macario might be able to recover in time for their title defence in Australia and New Zealand in July-August.
"While I'm excited and super-optimistic about my future as a footballer, I'm sad to share that I won't be physically ready for selection to our US World Cup team," Macario wrote on social media.
"The desire to return to play for my country has driven my training and fueled my everyday life. However, what's most important right now is my mental health and getting fit and ready for my next club season," she added.
Macario, who had become a key figure in the US midfield before her injury, thanked Andonovski and US Soccer for putting her "long-term health over any individual and collective ambitions."
"I'll be cheering hard for my teammates at the World Cup and I look forward to dedicating myself to fight to earn a spot for what I hope will be a long future on the US national team," she said.
Macario's absence is another blow to the holders after striker Mallory Swanson tore a patella tendon in her left knee during last month's friendly against Ireland.
No timeline for Swanson's recovery was given, but a torn patella tendon can often take at least six months to recover from.
The US are seeking a third straight World Cup title and will start their bid in Group E against the Netherlands, Portugal and Vietnam.
Several leading women's players have now pulled out of the World Cup with knee injuries, including England captain Leah Williamson.
England could also be without forward Beth Mead, who won the Golden Boot at Euro 2022, after she too suffered a torn ACL.
Canadian forward Janine Beckie is another who will not feature after a knee injury, as is Dutch star Vivianne Miedema.
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