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Rob Simmons ruled out of England Test

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The Qantas Wallabies' quest to retain the Cook Cup has hit a snag with Queensland Reds lock Rob Simmons being ruled out of this weekend’s Test against England at Twickenham. (1.30AM Sunday AEDT)

Simmons, who has been in impressive form this season, was ruled out on Wednesday (London time) after re-injuring his left knee.

He had been carrying a medial ligament strain since hurting it early in the Wallabies' Test against the All Blacks in Dunedin a fortnight ago but was expected to start against England at Twickenham on Saturday.

His absence could force coach Ewen McKenzie to start both James Horwill and Sitaleki Timani in the second-row.

McKenzie generally considers the two tight head locks best used in combination at No.5.

Waratahs second rower Kane Douglas is expected to come onto the bench.

The news is a setback for Simmons, who returned to form this year.

The Reds lock re-strained the ligament during a non-contact session on Tuesday but was given overnight in case the swelling reduced. Medical staff ruled him out on Wednesday, with his chances of playing against Italy also under a cloud.

The Wallabies will now rely on No.8 Ben Mowen to call the lineout with Horwill and Douglas as back-up.

The Qantas Wallabies will name the team to play England in London on Thursday morning local time (10pm, AEDT).