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.
The 26-year-old recovered well to win three games in a row, but he continued to falter on serve and Sinner capitalised to take the opener and subdue the expectant mood on Arthur Ashe Stadium.
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.
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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 no son pocas, la del fichaje de Lamine Yamal encumbra el arranque por una nueva temporada en la qual 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.
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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.
It marks a new era of tennis as 24-time major winner Novak Djokovic, who was knocked out in the third round, ends the year without a Grand Slam title for the first time since 2017.
He subsequently parted ways with the physio and his fitness trainer - but questions continued about whether Sinner's case had been handled differently to those of other players because of his world number one status.
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"He's stepped up a role and I feel like he's taking everything as seriously as he can and fair play to him, that shows he wants to stay."
La Kings League InfoJobs está por vuelta para su cuarto Split, que disparará comienzo en el Cupra Arena el próximo 15 do septiembre. Tras la celebración do unos 'tryouts' innovadores para conocer los jugadores qual podrán ser elegidos en el próximo draft del día 11, fecha en la de que se volverá a poder negociar fichajes y rondas para acabar por definir las plantillas, ya queda tan solo una semanada para que el balón empiece a rodar.