The Argentine has long-standing wrist pain which, after consultation, he decided not to rectify using surgery. He instead opted for rehabilitation that also meant missing the tournaments in Dubai and Indian Wells.
But it seems that the world number eight may have to go under the knife after all, declaring that he is unable to play in Miami this week.
"During these days I was training at the Crandon Park and followed the treatment to try to play in Miami, but I still feel pain in my left wrist and I don't feel competitive to go on court," Del Potro, 25, said on his Facebook page.
"It's a pity because this is a special tournament for me since there are many Latin fans and Argentines in particular.
"In the next few days I will visit my doctor again to determine the following steps.
"Sincerely, thanks everybody for the messages in this special moment."
Del Potro had been given a first-round bye in Miami, and had been due to face either compatriot Federico Delbonis or Ryan Harrison of the USA in the second round.
His problematic wrists saw the former world number four and 2009 US Open champion drop as low as 485 in the rankings, but after his return to the tour he got back among the world's elite and even won bronze at the 2012 Olympics.
It remains to be seen if he can recover from this latest setback.
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- Del Potro