Elina Svitolina, Alexander Zverev knocked out in Rome

Rome: Two-time women’s holder Elina Svitolina crashed out of the WTA and ATP Italian Open on Wednesday along with Germany’s Alexander Zverev as Serena Williams’s return to the courts was short lived with her knee injury flaring up to force the American star out of the final warm-up before the French Open in two weeks time.

Svitolina – who had a first round bye as fifth seed – held a match point at 5-2 in the third set before slumping 6-4, 1-6, 7-5 to Belarus Victoria Azarenka in a 2hr 14min battle at the Foro Italico which was twice interrupted because of rain.

Serena earlier announced she was withdrawing having just returned after two months out injured, before she was due to play her older sister Venus for the first time in 21 years in Rome.

The 37-year-old had eased past Sweden’s Rebecca Peterson in her first round match on Monday, but a day later could not continue “due to pain in my left knee”.

“I’ll be concentrating on rehab and look forward to seeing you all at the French Open and next year in Rome,” Serena said in a statement.

Her withdrawal sends Venus, the 1999 winner, through to a third round meeting with either Britain’s Johanna Konta or US seventh seed Sloane Stephens.

There are now doubts whether Serena can target a record-equalling 24th Grand Slam title in Paris, having played just nine matches this year, and one on clay.

Her last Grand Slam singles title was won at the Australian Open in 2017, where she was pregnant, breaking a tie with Steffi Graf for the most, and she is just one short of Margaret Court.

The three-time French Open winner revealed getting back to fitness has been tougher than she had expected.

Svitolina and Azarenka battled late into the night at the Foro Italico before former two-time Australian Open winner Azarenka won through.

Svitolina came back after the rain break to drop the second set but rolled off the first three games in the third, before being broken when serving for the match at 5-2 in the third set.

Azarenka saved match point and took the next game for love, rolling off five in a row to set up a meeting former French Open winner Garbine Muguruza or Danielle Collins for a place in the third round.

Collins advanced past former world number one Caroline Wozniacki who retired with a lower leg injury, after losing the first set 7-6 (7/5). Czech fourth seed Karolina Pliskova eased through to the third round along with Australian Ashleigh Barty, the eighth seed.

In the men’s competition, world number five Zverev, the 2017 winner and runner-up to Novak Djokovic last year in Rome, extended his terrible clay-court run, falling 7-5, 7-5 to Italian wild card Matteo Berrettini in the second round.

“The match that I played was horrendous,” said Zverev, who has won just four matches on clay this season, including a run to the quarter-final of the Madrid Open where he was the defending champion.