He was brought off in the second half and now drops down to the replacements bench to make way for Cuthbert.

Saracens prop Sam Wainwright is in line to make his debut from the bench, while Wyn Jones is named as a replacement.

Cuthbert, 32, also missed the end of the season for Ospreys with a hamstring problem and head coach Wayne Pivac admitted he had initially been carrying a back niggle, from which he has now recovered.

"Alex has been training really well," said Pivac.

"He's 6ft 4in, good in the air and runs all day. I think there will be plenty of aerial battles."

George North, starting again at centre alongside Nick Tompkins, will equal Stephen Jones' record as the most-capped Wales men's international back of all time with 104 when he takes to the field on Saturday.

Wainwright receives the nod ahead of Scarlets' Harri O'Connor - another player untried at this level - to deputise for Dillon Lewis.

The 24-year-old comes in for Tomas Francis, who has returned home after suffering concussion in the first Test defeat.

Wainwright replaced the injured Leon Brown in the original squad.

With Samson Lee also injured and Francis initially travelling to South Africa with a back problem, Pivac had brought Wainwright and O'Connor into the squad despite the pair having little exposure to top-flight match action.

Wainwright has played 15 matches for Saracens this season, with three starts and 12 replacement appearances.

Those three starts came in the Premiership Cup, with one further replacement appearance.

Wainwright's remaining games amounted to 48 minutes in eight replacement appearances in the Premiership and 36 minutes in three games off the bench in the European Challenge Cup.

"Sam has been very excited to join us," added Pivac.

"From day one he's been training really well. I know he's over the moon at his selection in the matchday 23 and his family are over here so he's looking forward to a big day."

Pivac has made three personnel changes to the matchday 23 squad compared to 19 made by Springboks opposite number Jacques Nienaber, who has altered 14 of the starting side.

Former Wales and British and Irish Lions legend Sir Gareth Edwards says that South Africa selection policy disrespects Wales and devalues the series, a stance Pivac does not accept.

"It hasn't changed our preparation at all," added Pivac

"It's going to be 15 rugby players in green shirts. We're expecting more of the same.

"They are a very experienced team no matter what combinations they put out. This side is one to be respected and not taken lightly.

"It was a great atmosphere last week and we're expecting more of the same from the crowd in Bloemfontein this Saturday."

Wales team to play South Africa: L Williams; Rees-Zammit, North, Tompkins, Cuthbert; Biggar, Hardy; G Thomas, Elias, D Lewis, Rowlands, Beard, Lydiate, Reffell, Faletau.

Replacements: Lake, Wyn Jones, S Wainwright, Alun Wyn Jones, Navidi, T Williams, Anscombe, Adams.