Matteo Berrettini has officially withdrawn from the French Open as his nightmare injury run continues. The world No. 28 has not played Roland Garros since his quarter-final run in 2021 after years of on-and-off physical issues. Berrettini also retired from his last two tournaments, the Masters 1000s in Madrid and Rome.

Berrettini's withdrawal was announced just three hours before the main draw ceremony is due to take place in Paris on Thursday afternoon. The Italian will be replaced by a lucky loser.

The announcement comes after Berrettini retired from his home tournament, the Italian Open, earlier this month. He was trailing sixth seed Casper Ruud 7-5 2-0 when he threw in the towel, and later admitted that he almost pulled out before the match.

"Today until ten minutes before the match I thought I couldn't make it. Then I said, whatever, I'm going to try, come on. I was surprised at how my body reacted up to a certain point," Berrettini said following his third-round retirement.

"Then I felt another pull, towards the end of the first set, and after that I couldn't remain in the match, remain focused. I had to pull out one more time.

"I did not want to retire, but then I know what happens if I do not stop, I have to spend three months not playing, every time I sneeze I jump. I did not want that thing there to happen again."

Berrettini also retired while facing Britain's Jack Draper in the third round of the Madrid Open a few weeks ago. The 2021 Wimbledon runner-up has since revealed that he is facing an oblique injury, similar to an issue that sidelined him from the tour a few years ago.

"It is close to a point where I have hurt before, I don’t know what is wrong with my obliques. The feelings, unfortunately I know them well because I’ve been there over and over again," he added.

It's the fourth year in a row that Berrettini has been forced to miss the French Open. He pushed Novak Djokovic in a tense four-set match in the 2021 quarter-final, and has not played since.

In 2022, Berrettini missed the entire clay season after undergoing emergency surgery for a hand injury.

An abdominal and oblique issue kept him out of the tournament in 2023 and, last year, he said he was "not quite ready" to return to competiton in Paris after suffering with illness.

It's been a tough few years for Berrettini, who peaked at No. 6 in the world three years ago and reached his only Grand Slam final at Wimbledon in 2021, losing to Djokovic.

When he's been healthy, he's proved he can still be one of the best players. The current world No. 28 upset Djokovic in the first round of the Qatar Open in February and, a month later, he reached the Miami Open quarter-final.

Berrettini will be hoping to recover in time for the grass swing as he thrives on the surface. He is defending 165 ranking points from reaching the Stuttgart final last year and is a two-time former champion at London's Queen's Club.