For the third year in a row, Novak Djokovic has been knocked out early at the Monte Carlo Masters. (More Tennis News)

Playing in only his second match on clay this season after a one-month pause, the top-ranked Serb lost 4-6, 7-5, 6-4 against Lorenzo Musetti on Thursday.

Still adapting to the slow surface, Djokovic struggled with his movement in a sloppy display, dropped his serve eight times and could not find a solution to counter his Italian rival’s solid baseline shots.

“Well, (my) feeling is terrible after playing like this, honestly,” said Djokovic, who is expected to resume his preparations for the French Open next week at the Srpska Open in Bosnia-Herzegovina.

A two-time champion at Monte Carlo, Djokovic lost his opening match on the French Cote d’Azur last year and exited the tournament in the third round in 2021.

Djokovic got off to a strong start but lost control of the match in the second set when he was broken five times as both players struggled with accuracy in windy conditions.

Djokovic led 4-2 but could not hold onto his lead as Musetti’s mix of clever drop shots and deep groundstrokes put the 22-time Grand Slam winner on the back foot. Novak Djokovic was broken at love in the 11th game and was furious at the changeover, stomping on his racket and destroying it.

Musetti kept his cool in the next game to serve out the set and force a decider.

The match was suspended by rain for about an hour with the score 6-4, 5-7, 1-1 and Djokovic up 40-30 on his serve. Musetti broke for a 4-3 lead and concluded on his fourth match point.

“I am struggling not to cry,” Musetti said. “It is an emotional win because it was a really long match. Three-hour match and suspended by rain. It was not easy conditions because it was a little bit windy and cold. Not like we used to play in the recent days. I am really proud of myself and I can see on the screen. I am struggling not to cry because it is a dream for me.”

The 16th-seeded Musetti — who led 2 sets to love against Novak Djokovic at the 2021 French Open before retiring in the fifth set, will take on Jannik Sinner in the quarterfinals.

The seventh-seeded Sinner came from behind and saved a match point to get past No. 10-seeded Hubert Hurkacz 3-6, 7-6 (6), 6-1.

Sinner trailed by a set and a break then came out on top of a 22-shot rally when down 6-5 in the tiebreaker to remain in the match. Hurkacz lost the next two points and threw his racket in anger, then totally lost his focus in the decider.

“Playing against him, I knew already from the beginning that it was very tough to get into the rhythm,” Sinner said. “I think he served incredible in the first one-and-a-half sets, and when I broke him the first time the momentum changed a little bit.”

Also, third-seeded Daniil Medvedev saved two match points in the deciding-set tiebreaker to rally past Alexander Zverev 3-6, 7-5, 7-6 (7).

Medvedev advanced to the quarterfinals in Monte Carlo for the second time and will next face Holger Rune. The sixth-seeded Rune advanced without playing when Matteo Berrettini withdrew due to an injury.

German qualifier Jan-Lennard Struff took another step in his comeback from an injury as he upset fourth-seeded Casper Ruud 6-1, 7-6 (6).

Having been ranked 29th, Struff dropped as low as No. 168 after sustaining a foot fracture last year during a match in Miami.

Struff has enjoyed a good start to the season and returned to the Top 100 last month but had not beaten anyone in the Top 10 since June 2021. His aggressive style of play resulted in 37 winners and 23 points won at the net against Ruud, who dropped his serve four times.

Struff ended Ruud’s nine-match winning streak on clay. The 2022 French Open runner-up had won his past two tournaments on the surface, in Gstaad last July and in Estoril last week.

Struff will next be up against 2021 runner-up Andrey Rublev, who beat Karen Khachanov 7-6 (4), 6-2 at the Country Club.

“We know each other too well,” Rublev said. “The first set was only mental. We didn’t show some tennis skills. But it was tough to show skills because the wind was really hard and the court was slippery and it was tough to do something.”

Two-time defending champion Stefanos Tsitsipas defeated Nicolas Jarry 6-3, 6-4.

“I had to deal with a few (tough) points, especially when he had break points,” said Tsitsipas, who next plays eighth-seeded Taylor Fritz. “I dealt with those situations very maturely and played precisely.”