Cyclops Lesion vs. early onset arthritis? How to tell?

Posting on behalf of my wife that's a year into her ACL journey and growing increasingly frustrated with recovery.

Long story short - she's a 44 yo strong mountain  (trail runner, skier, yogi) that tore her ACL in a ski accident January 2024.  We were living in France for the time, and she got ACL reconstruction surgery in April of 2024 by a well-renowned surgeon near Chamonix that specializes in ACL operations.  Everything seemed like it was going very well - she had access to great PT 3-4x per week and was recovering quickly.  She started some light running again around June, and did a 20km pain-free loop in July before we returned to the States.

In August she started having some severe stiffness, instability, and pain in her kneecap.  Her PT care here in the States is definitely less than in France, but the PT initially thought it was a meniscus tear, and then runner's knee, and then finally ordered an MRI.  The initial read of the MRI showed a cyclops lesion, which seemed congruent with her symptoms.  She saw the knee surgeon in December and this is what he suggested as well - he was ready to operate, but she was scared by his incredibly shaky hands, and after asking around Kaiser it quickly became apparent that he was not recommended by anyone for this type of surgery.

She finally got an appointment with another, more well-regarded surgeon today.  His take on the situation is that yes, she has some scar tissue, but from looking at the MRI he thinks her symptoms are more from arthritis and thinning of the patellar cartilage.  He's willing to operate and remove the scar tissue, but he is also not very confident that anything will get better.

She's frustrated because she's been hoping all along that this surgeon would do a good job clearing out this scar tissue and her knee would be relatively pain free again.... she had no issues with this knee before the accident or the initial operation.Has anybody been down this path before, trying to differentiate between very early onset arthritis and a cyclops lesion?  Any advice?  It's going to be hard for her to motivate for another surgery and time off work (she's a yoga teacher) if she doesn't think it's going to be effective.

Thanks for any advice!!