The Chelsea midfielder, described by Ghana coach Milovan Rajevac as the leader of his team, has a long-term knee injury and, though he has been named in the preliminary squad, could miss the tournament in South Africa.
The stocky, quietly-spoken Essien has played only half a match since December when he injured a hamstring in the UEFA Champions League. He returned during January's African Nations Cup, playing 45 minutes for his country, but then suffered a serious knee injury in a collision with team mates during training in Angola.
His chances of returning for the World Cup remain unclear with Essien last month telling the Chelsea website: "The last thing I want is to rush back and cause more problems down the line. If I make it for the World Cup then great -- if not, I have my whole career ahead of me."
Ghana have already played a major tournament without Essien, and flopped. He missed the 2006 Nations Cup in Egypt, where his absence was blamed for the country's disappointing showing.
He made up for it at the World Cup finals six months later when the Black Stars progressed past the first round on their debut, becoming the only one of the five African sides to go through.
Formerly Africa's most expensive footballer, the 27-year-old Essien has also had considerable success at club level.
He has won league titles at Chelsea in England, the latest of them this season, and before that with Olympique Lyon in France.
A member of the Ghana team at the 1999 world under-17 championship in New Zealand, he was invited for trial at Manchester United but failed to impress. His career was stymied for a while as agents unsuccessfully touted an unhappy Essien to clubs in Europe.
Bastia signed him in 2000, using him in defence, and it was only an injury crisis at the club that led to him being moved to centre midfield, where he quickly proved his prowess with his driving play and relentless work rate.
Essien has consistently been a top-three finisher in the African Footballer of the Year poll since 2005 but has never won the award.
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