If Hideki Matsui's left knee fills with fluid again, GM Brian Cashman believes it will be impossible for the Yankee DH to avoid a second knee surgery.

"If the knee swells up we are dealing with last call," Cashman said last night after Dr. Scott Rodeo recommended to Matsui that surgery was required.

Cashman admires Matsui, who has the knee drained three times, wanting to give it another try even though the odds of Matsui playing again this year are long.

Matsui will go through a rehab process - likely 10 days - and reassess where he is at. Surgery would end Matsui's season.