Derby boss Paul Jewell fears midfielder Giles Barnes may not return to action until October.
The 19-year-old has been sidelined since the end of February with a knee injury that led to him visiting renowned surgeon Richard Steadman in Colorado.
Barnes is due to return to the United States next month for an assessment, and a potential arthroscopic operation to view inside the joint.
"They seem quite pleased with things, but Giles will not be fit until September or October," insisted Jewell.
For the second successive year the teenager will miss pre-season after he sat out last summer with a broken foot.
Jewell, meanwhile, has confirmed Hossam Ghaly has played his last game for the Rams.
The Egyptian midfielder joined Derby in January on a loan deal from Spurs, starting 14 of 16 matches.
At one stage Jewell was keen on signing Ghaly given his form, but the County boss appears to have had a change of heart.
"Hossam had a really good spell for us, and when I spoke to him he said he would like to stay in the Premier League," said Jewell.
"But if he couldn't find anything in the Premier League, he would come to Derby.
"But Hossam has played his last game for us now, I think, and we will be looking elsewhere."