McKennie, who has been the United States' best player for large stretches of qualifying, exited Juventus' 1-1 Champions League draw with Villarreal on Tuesday after suffering two fractures in his left foot, sources confirmed to ESPN's Jeff Carlisle. Juve are yet to provide an official confirmation.
It is unclear how long the Texas native will be sidelined, but it's hard to allow for the possibility he will be ready for any of the USMNT's final three games against Mexico (March 24), Panama (March 27) or Costa Rica (March 30). Injuries similar to McKennie's usually take between eight and 12 weeks to heal.
The news leaves U.S. coach Gregg Berhalter with a difficult question: How to replace McKennie in the center of the park?
The quick, and obvious, answer is he can't. There is no one in the U.S. pool who can replicate what McKennie does or anyone who has been playing anywhere near his level of late. If there were a player on the roster the U.S. could least afford to lose, it was McKennie.
With that understanding, there are interesting options.
Let's start with another player in the news this week because of an injury, Borussia Dortmund midfielder Giovanni Reyna. Reyna recently returned to the field for Dortmund after suffering an injury in the first match of World Cup qualifying on Sept. 2, but the 19-year-old left Sunday's match against Borussia Monchengladbach in tears after picking up an injury.
On Monday, BVB announced that Reyna's injury was not as bad as initially feared and he was expected to return to training in two weeks. If Reyna is fully fit and playing regularly ahead of the World Cup qualifiers, he will be the obvious choice to slot into McKennie's advanced midfield role. While he's predominately played on the right wing during his brief time with the national team, the midfield role is something he's comfortable in and can play at a high level.
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Even if Reyna has a speedy recovery and is available for selection, though, his fitness -- coupled with the reality that he hasn't been with the national team in months -- will be a concern. There will almost assuredly have to be a by-committee solution.
Last window, Berhalter rotated Yunus Musah out for the final game against Honduras and handed Luca de la Torre his first start of qualifying. De la Torre has performed well for Heracles in the Netherlands this season, and that form carried over in an eye-opening performance for the U.S., after which Berhalter named him the coaches' man of the match. His ability to progress the ball centrally on the dribble proved valuable and his familiarity with the position in Berhalter's system makes him a good option to step in the starting XI.
Brenden Aaronson also deserves consideration. Like Reyna, he's mostly played on the wing for the national team but has played centrally and should be familiar with the patterns of play. In the Champions League against Bayern Munich last week, Aaronson was a man on fire playing as a No. 10 for RB Salzburg and, while the U.S. system asks for different traits, his relentless energy will cause problems for opponents in the qualifiers.
Kellyn Acosta is coming off his best game for the national team, slotting in for Tyler Adams at defensive midfield against Honduras, and is an enticing option to play higher up the field just to get him on the field for his set-piece deliveries.
Berhalter could also look to Sebastian Lletget, Cristian Roldan or Gianluca Busio, all of whom have been roster regulars, but they figure to be more likely to be called on off the bench than in a starting role.
There is also the possibility Berhalter could implement a system change and play the 3-4-3 he has experimented with at times, but that seems like a drastic gamble to take considering the stakes.
Currently, the U.S. sit in second place in the CONCACAF standings with 21 points, ahead of Mexico only on goal differential. It's an enviable position within the region, but with the U.S. holding just a four-point edge on Panama and a five-point lead on Costa Rica they still have work to do as only the top three places receive an automatic berth to the World Cup in Qatar. If the U.S. finish in fourth place, they will play a one-game playoff, likely against New Zealand, in June to qualify.