Sami Khedira (right) goes past Claudio Marchisio.

Germany and Real Madrid midfielder Sami Khedira’s World Cup hopes hang in the balance after he was ruled out for around six months with a torn cruciate ligament suffered in Friday’s 1-1 draw against Italy, team doctors said yesterday.

Khedira, who also tore another ligament in his right knee during the incident, will undergo surgery.

“He will need to be operated on but we are hopeful he could be fit in time for the World Cup,” team doctor Hans-Wilhelm Mueller-Wohlfahrt said.

Germany take on England at Wembley in another friendly international on Tuesday.

“This is a bitter setback for Sami. But he always thinks positively and that is why I am optimistic he will be ready and fit when the World Cup starts,” coach Joachim Loew said.

Khedira had formed a superb holding midfield partnership with Bastian Schweinsteiger, who himself underwent surgery last week for a persistent ankle injury.

Schweinsteiger is not expected to return before the end of the winter break in January.

Loew said he had decided to travel to London without captain Philipp Lahm, first-choice keeper Manuel Neuer and playmaker Mesut Ozil in order to give other players a chance.

“They are absolutely part of the main structure of this team and what is important for me now is to give other players in these key positions a chance to show what they can do against a big opponent like England,” he said.

Central defender Per Mertesacker, however, will return after sitting out the Italy game with flu.

Lahm told reporters he was disappointed that the hoodoo against Italy continued.

The guests struck the woodwork three times and nearly stole victory with the last kick of the game, and Lahm suggested it would not have been an undeserved outcome.

“We could have won easily,” he told reporters.

“We had the best chances and we hit the woodwork three times.”

As close as they got to beating Italy for the first time since 1995, they could also have lost to a well-disciplined Italy who may not have hit the post at all, but came closer on other occasions.

“You could tell that both sides wanted to win it,” Lahm added.

“It was a very intense game. It’s always good to have tests like this, to see what we still need to improve on and what we are doing well.”

That is precisely why Italy and, on Tuesday, England have been chosen as friendly opponents in Germany’s final tests of 2013, according to Loew.

“We knew it wouldn’t be a friendly game against Italy,” he said.

“That is why we chose these games, to play at a very high level.

“Italy are tactically and defensively very strong, changing things around a lot during games.

“They are brought up to play like this from birth so it’s good to try things out against them.”