Manchester City are primed to make wholesale change this summer after Pep Guardiola admitted they cannot continue carrying injured players.

John Stones is fearing months on the sidelines with a thigh issue – his fourth setback of the season - and may need surgery after pulling up five minutes into Wednesday's defeat at Real Madrid.

Collectively, City's squad have missed an astonishing 100 Premier League matches between them this season through fitness.

Guardiola pulled no punches in confirming Mail Sport's story that the club are ready for a clear out.

'We have to sit down with the doctors, the players, agents and be clear that some of them cannot sustain playing every three days,' Guardiola said.

'This is the reality. A lot of players cannot sustain what we have done in the past every week in, week out. Playing in different competitions, travel without the problems. You tell me where my concern is? Just that.

'We deserve to have a bad season, it can happen. The reality is for the future if we want to be there again, in the latter stages of the Champions League, we need players fit and available. Of course I am concerned.

'It can happen sometimes but already it happens many times. It's so, so demanding - the teams are quicker, faster, stronger and we cannot handle it right now. I remember before the first leg against Madrid we had all central defenders back and I said, "guys, now you will see". One week later, two central defenders out for months. The season has been like that.'

Alongside Stones, Akanji is facing eight weeks out with a groin injury. Ruben Dias and Ake, with Abdukodir Khusanov, are Guardiola's central defensive options for the foreseeable future – starting when meeting league leaders Liverpool on Sunday.

Stones, Kevin De Bruyne, Nathan Ake, Ederson, Jack Grealish and Jeremy Doku have all suffered multiple injuries this year.

De Bruyne – whose contract expires at the end of the season – was an unused substitute at the Bernabeu in midweek and only made the bench when City were humiliated 5-1 at Arsenal three weeks ago.

'The relationship with Kevin is exceptional - I cannot thank him enough for what he has done for me and the team,' Guardiola added. 'It's just a decision. Normally I don't speak to them about why they don't play.

'It's decisions on what I have seen on few reasons. It's never, ever personal or that I am upset (with them).

'Maybe for the demands of the way we need to play, for the absence of strength that we have and physicality, we need more control and not up and down. It's not personal.'