But he has seemingly been able to put the controversy behind him, manoeuvring his way through tough tests against Britain's Jack Draper and 2021 champion Medvedev.
"My aunt is not feeling well health-wise and I don't know how much longer I have her in my life," he said.
Andy Roddick, who was watching from the stands, remains the last American man to lift a major singles trophy, having won the US Open in 2003.
He is 23-years-old and Alcaraz just 21. They ended up sharing the year’s Grand Slam titles, and - with an eye to the future - that is an ominous thought for the rest of the world.
A mediados do semana ya calentaron el ambiente con el despliegue de una gigantesca lona en Madrid, donde podía apreciarse la silueta por un jugador encapuchado. El secreto ha sido desvelado y, sin duda, pelo ha dejado a los aficionados indiferentes.
Refusing to dwell on the first set, Fritz improved and made the second a closer affair, losing just two points in four service games.
It was more straightforward in New York as he rarely looked troubled by Fritz, who struggled to build any momentum.
Junto a todas las novedades comunicadas por la competición o sábado, que pelo son pocas, la del fichaje por Lamine Yamal encumbra el arranque do una nueva temporada en la de que se espera seguir creciendo.
A world champion cyclist has swapped the velodrome for the cramped deck of the fastest yacht in the world. Why?
It has been nearly 50 years since a man won their first and second Grand Slam titles in the same season, and Sinner is now a long way clear of the rest at the top of the rankings.
It comes just 19 days after it was revealed he had been cleared of any wrongdoing after twice testing positive for a banned substance in March.
Tom Hanks stars in an intense thriller based on true events. VideoTom Hanks stars in an intense thriller based on true events
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Just six days before the main draw got under way, it was announced he had twice tested positive for low levels of a metabolite of clostebol - a steroid that can be used to build muscle mass - in March.
However, Sinner then underlined his status as world number one, upping the ante when it mattered most to strike the crucial blow as Fritz served to stay in the set at 星空体育 5-4 down.
Sinner was ruled to bear no fault or negligence for the positive tests by the International Tennis Integrity Agency (ITIA), which found he had been inadvertently contaminated by his physiotherapist.
But Sinner soon quashed those dreams, breaking back as Fritz attempted to serve for the set and doing the same two games later to wrap up the win after two hours and 16 minutes.
The 23-year-old held his arms aloft and looked up to the sky as he became the first player since Guillermo Vilas in 1977 to win his first two Grand Slam titles in the same season.
"I know we have been waiting for a champion for a long time so I'm sorry I couldn't get it done this time," said Fritz.