Question
My mother was recently diagnosed with “possible” PVNS of the knee joint. I say “possible” because the lab was unable to definitively identify the tissue removed during her arthroscopic procedure to lessen the pain in her left knee. Now, her knee is swollen worse than before and her doctor wants to do knee replacement and she is in agreement because she is tired of the unrelenting knee pain. I have seen that it can be treated with radiation and/or synovectomy also. My mother has other comorbid conditions consisting of ulcerative colitis, hypertension and newly diagnosed diabetes type II. I am concerned that she is consenting without exploring other possiblities. I am a pharmacist and would like some further resources to give her on alternative therapies. She lives in San Antonio, Texas. Her doctor is having to consult a colleague since he is unfamiliar with PVNS.
Answer
Unfortunately, there is not a lot of information on pigmented villonodular synovitis (PVNS). Radiation has been tried but to my knowledge there are no controlled trials and results have been mixed. Surgery is considered treatment of choice. I would seek an orthopedist who specializes in bone tumors. At Hopkins, Dr. Frank Frassica is the specialist.
