Stephen Larkham will miss Australia's World Cup quarter-final against either England or Tonga after he was forced to undergo a second knee operation in the space of eight days.

The 33-year-old had an arthroscopy on September 16 to remove a floating bone fragment which was causing his right knee to lock up. He returned to hospital on Monday night for a second operation after his knee became infected and is not expected to be fit until at least the semi-final stage.

"Stephen woke up with some pain and swelling on Monday and had another procedure overnight to clean out his knee," said Connolly. "It's a big setback for Stephen as he's now definitely out of this week's match and the quarter final."