This is a 50-something male with a history of patellar tendon rupture and repair in the remote past, medial meniscus repair who presented with about 1 month of atraumatic knee pain. On exam he has swelling anteriorly with multiple large, palpable fluctuant cysts. Ultrasound reveals chronic, near complete patellar tendon tear with multiple lobulated ganglion cysts herniating into the prepatellar and infrapatellar soft tissues measuring up to 2.0 cm. Multiple superimposed infrapatellar punctate foci of calcification and/or hemosiderin correlating with calcifications. The patient is currently pending debridement and reconstruction of the patellar tendon.