As yet another unforced error from Novak Djokovic sent him down a break in the fourth set of his tense, gripping tussle with Francisco ­Cerúndolo, the world No 1 reckoned with the very real prospect of his earliest defeat at Roland Garros in 15 years. He was limping, wincing, and struggling to find his range as his Argentinian opponent seemed to laser forehand winners at will.

But nobody knows how to plot their way back from a desperate deficit like Djokovic. Despite ­trailing by two sets to one for a second match in a row and ingesting a cocktail of painkillers for a sore knee, he found a way through, defeating Cerúndolo 6-1, 5-7, 3-6, 7-5, 6-3 after 4hr 39min to return to the quarter-finals of the French Open.

Djokovic spoke at length about the knee injury he sustained after a slip in the second set and he said he was uncertain about whether his knee would allow him to continue competing in the tournament.

“The adrenaline, of course, that kicks in, that helps you go through the tournament,” he said. “Sometimes it is a match or two, sometimes the entire tournament. Good thing about the slam is that you have a day between that will allow hopefully the healing process to happen more efficiently for me. That’s it. I don’t know what will happen tomorrow or after tomorrow if I’ll be able to step out on the court and play. I hope so. Let’s see what happens.”

A day and a half after ­Djokovic closed off his third-round victory against Lorenzo Musetti at 3.07am, the ­latest finish at this tournament in its 133‑year history, he returned to the same court striking the ball with total freedom as he rolled through the first set without issue.

Early in the second set, ­however, ­Djokovic slipped on the court and injured his knee. In the subsequent games, he twice called out the trainer for treatment at the ­changeover. He also had a heated ­discussion with Wayne McKewen, the ­tournament supervisor, ­expressing his ­frustration at the state of the court. At 5-6, an error-strewn service game from ­Djokovic gave Cerúndolo the second set.

While Djokovic floundered, ­Cerúndolo was excellent. Despite his slight build, the 25-year-old 23rd seed possesses some of the most vicious forehands in the game, which cuts through all conditions with supreme pace and spin. He put his opponent under ­unabating pressure, also ­mixing in drop shots, and as Djokovic moved gingerly he soon trailed by two sets to one and 2-4 in the fourth set.

No matter how beaten Djokovic may appear, the lesson from his past 13 years of dominance is that he will almost always find a way back. According to the Serb, in this case the second wind came with the help of painkillers: “I got the medications, and then after the third set was done, I asked for more medications, and I got them. That was the maximum dose that kicked in, as I heard now from [a] doctor after 30 to 45 minutes, which was just about the time, kind of end of the fourth, when things started to really improve for me.”

As the 37-year-old began to ­connect with his return of serve and consistent depth with his groundstrokes, ­Cerúndolo began to feel the pressure. After breaking back for 4-4 in the fourth set and calling on the crowd to guide him through, ­Djokovic saved a break point in a dramatic service game at 5-5 before forcing a fifth set.

To his credit, even as he trailed a break in the fifth set, Cerúndolo fought desperately until the end and he forced Djokovic to win the match from him. But Djokovic has been in these positions so many times before. After spending more than nine hours on court in the past two matches alone and barely holding on, the defending champion stayed alive.

If he takes to the court on Wednesday, Djokovic will next face Casper Ruud, the seventh seed, who defeated the 12th seed Taylor Fritz 7-6 (6), 3-6, 6-4, 6-2 to return to the quarter‑finals.

Alex de Minaur broke through to reach his first quarter‑final at Roland Garros, defeating Daniil ­Medvedev, the fifth seed, 4-6, 6-2, 6-1, 6-3. The Australian will next face Alexander Zverev, who came through another five-set battle to beat Holger Rune 4-6, 6-1, 5-7, 7-6 (2), 6-2 in the evening match.