Barcelona's goalkeeper Marc-Andre ter Stegen is removed from the pitch...

Barcelona's goalkeeper Marc-Andre ter Stegen is removed from the pitch on a stretcher after picking up an injury during a Spanish La Liga soccer match against Villarreal at the La Cerámica stadium in Villarreal, Spain, Sunday, Sept. 22, 2024. Credit: AP/Alberto Saiz

MADRID — Barcelona extended its perfect start to the Spanish league season but lost goalkeeper Marc-André ter Stegen with a serious knee injury on Sunday.

Barcelona routed host Villarreal 5-1 to pick up its sixth straight victory in the competition, but saw captain Ter Stegen leave the match on a stretcher just before halftime after his right knee buckled when he fell awkwardly after going up for a ball crossed into the area.

Barcelona president Joan Laporta said the injury appeared to be a torn ligament but more tests would be conducted. Local media reports said Ter Stegen went from the stadium to the hospital in an ambulance, and left the hospital in a wheelchair.

“This injury makes us sad. I think the injury will be huge but we have to wait for more information," Barcelona coach Hansi Flick said. “We have to accept it. It's not easy. It was an accident. It's very tough.”

Players from both teams immediately called for medical assistance after Ter Stegen fell to the ground in pain. He was replaced by reserve goalkeeper Iñaki Peña.

Real Madrid goalkeeper Thibaut Courtois, who missed most of last season with a similar injury, showed his support to Ter Stegen with a message on X, saying that it hurt to see his colleague leave the field like that and that he hoped he would recover soon.

It was the latest injury to Flick's Barcelona, which is already without Dani Olmo, Frenkie de Jong, Gavi and Ronald Araujo, among others.

Barcelona's goalkeeper Marc-Andre ter Stegen is removed from the pitch...

Barcelona's goalkeeper Marc-Andre ter Stegen is removed from the pitch on a stretcher after picking up an injury during a Spanish La Liga soccer match against Villarreal at the La Cerámica stadium in Villarreal, Spain, Sunday, Sept. 22, 2024. Credit: AP/Alberto Saiz

Robert Lewandowski scored a pair of first-half goals and Raphinha added two after the interval, with Pablo Torre also scoring for the Catalan club in the second half. Lewandowski now has six goals from the first six matches and leads the league in scoring.

Ayoze Pérez scored the only goal for the hosts in the 38th, with his team already trailing 2-0. Villarreal had entered the round in fourth place, four points behind Barcelona.

Barcelona has outscored its opponents 22-5 in its first six games. It has a four-point lead over Real Madrid, which beat Espanyol 4-1 on Saturday.

Atletico Madrid held

Atletico Madrid missed a chance to keep pace with Barcelona after a 1-1 draw with Madrid rival Rayo Vallecano.

Barcelona's Raphinha celebrates with Lamine Yamal after scoring his side's...

Barcelona's Raphinha celebrates with Lamine Yamal after scoring his side's 5th goal against Villarreal during a Spanish La Liga soccer match at the La Cerámica stadium in Villarreal, Spain, Sunday, Sept. 22, 2024. Credit: AP/Alberto Saiz

Rayo took the lede through Isi Palazón in the 35th minute, and Conor Gallagher equalized for the visitors in the 49th.

Atletico was coming off three straight wins in all competitions.

In other results Sunday, Getafe and Leganes drew 1-1 and Athletic Bilbao defeated Celta Vigo 3-1.