Conflicting Opinions on My Knee Surgeries: Meniscus or ACL?
**Contextual Overview:** I am a 34-year-old male, standing 6 feet 3 inches tall and weighing 180 pounds, with a history as a collegiate track athlete specializing in hurdles. [*Note: Some information may be less significant but has been mentioned by my physician as potentially relevant.*] During my collegiate years, I sustained a rupture to the tendon that links my Semimembranosus muscle to the tibia. The surgeon recommended against surgical intervention, resulting in natural atrophy of the muscle. Consequently, I developed scar tissue and a peculiar "faux tendon" situated behind my right knee that connects my hamstring to my tibia. Transitioning to a career as a chef, I found myself on my feet for extended periods. In the year 2022, I began experiencing sharp, pinching sensations deep within my right knee. An MRI subsequently revealed a ganglion cyst attached to my ACL. Following this, I underwent surgery for its removal and, after approximately three months of rehabilitation, I felt significantly improved. However, as the following year progressed, the pain re-emerged. A further MRI disclosed that the cyst had returned, now larger at about 18x17x21mm. My doctor recommended the same surgical procedure, which was performed last August. He indicated that during the first procedure, he had taken a cautious approach to avoid damaging the tendon but was more assertive in the subsequent operation. The relief was noticeable, and I felt fantastic right away. Yet, less than two months later, the discomfort returned. **Current Situation:** An MRI conducted this past Monday indicated that the cyst had reappeared, roughly the same size as before. Biopsy results from the previous cyst showed no signs of malignancy. During my recent consultation, the physician clarified that the cyst resides within my tendon, which explains its recurrence and why additional excision attempts may not succeed. His sole recommendation is to pursue a total ACL reconstruction to completely eliminate the cyst growth from the tendon. Seeking further insight, I obtained a second opinion from The Stone Clinic in San Francisco, where the assessment suggested the issues stem from a tear in the posterior medial meniscus. However, I have shared my MRI with three additional radiologists, none of whom have confirmed this diagnosis. I would greatly appreciate your thoughts on this matter!
Answers (1)
2/5/2026, 3:30:50 PM
OpenHealth AI
It's understandable to feel confused about conflicting opinions regarding your knee surgeries, especially with the complexity of your situation. Here’s a breakdown of your current situation and some actionable steps to consider.
Main Points:
- Your ganglion cyst has returned despite previous surgeries, and its location within the tendon is complicating treatment.
- There are differing opinions on whether the ACL reconstruction is necessary or if the meniscus tear is the primary issue.
Explanation:
Your knee history indicates ongoing issues, particularly with the ganglion cyst associated with your ACL. The recurrence of the cyst after surgical removal suggests that it may be related to the integrity of the tendon itself, making complete removal much more challenging. Meanwhile, the recommendation for ACL reconstruction aims to remove the cyst more definitively by addressing the underlying anatomy.
The second opinion proposing a meniscus tear raises valid concerns but also needs to be weighed against the MRI findings and the professional consensus of several radiologists. Given the complexity of your knee, a clear pathology needs to be established before pursuing further surgery.
Next Steps:
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Symptom Management: Focus on pain management. Using ice packs on your knee and over-the-counter medications like NSAIDs (ibuprofen or naproxen) can reduce inflammation and help manage pain in the short term. Ensure to follow dosing guidelines.
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Rethink your Options: Since you’ve received conflicting opinions, seek more clarity with another orthopedic surgeon who specializes in knee injuries, particularly someone experienced with both meniscus issues and ganglion cysts.
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Personalized Imaging Evaluation: Consider discussing advanced imaging options like a contrast MRI with your doctor. This can provide better visualization of soft tissue and give more clarity regarding the meniscus and ACL condition.
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Physical Therapy Consultation: Engaging with a physical therapist experienced in sports injuries could provide insights into strengthening exercises for your knee while also addressing functionality, which may alleviate some symptoms.
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Patient Education and Advocacy: Prepare a list of questions for your next appointment, such as potential outcomes of either surgical approach and the risks involved. Understanding both procedures will empower you to make an informed decision.
Remember, ensuring you’re comfortable and confident with your treatment plan is crucial. Be gentle with yourself during this process; navigating complex medical advice can be stressful, and you deserve clarity and relief.
If you have any additional specific questions about your treatments or next steps, feel free to ask!
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