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Thursday, March 28, 2013
Unfortunately, many of the physicians who are damming radiation treatment for PVNS have some type of association and or financial interest in promoting chemotherapy drugs and trials. I have kindly asked some of these physicians what they are basing there opinions on, and each has declined to provide any type of answer besides a personal opinion.
Nearly a year after making my decision to have external radiation treatment after my first synovectomy....I'm seeing a trend toward more aggressive treatment on the onset of pvns and not waiting until there has been a recurrence. I honestly don't know if this is a good thing or not. Once again only time will tell. Obviously my thoughts were to throw every weapon at it, to kill it off on the initial assault, and so far it has worked for me. I can't say this is the right route for others because there are just too many variables in each case, and I'm not a doctor. The information that I share, are links to empirical studies, otherwise it's just my personal opinion based on my experience, and it should not be taken as medical advice.
Friday, March 15, 2013
Click here to read a good article about staph infections.
In 2008 I nearly lost my foot due to a MRSA (staph) infection that entered through a tiny scratch. You may realize that the hospital is a harbor for life and limb threatening bacteria, but have you thought about how they could find their way into your body?
First of all, studies show 25-30% of people in the general population carry staph without any signs or symptom and this statistic is much higher in hospital personnel.
Secondly, staph is easily passed on through physical contact, or even when people touch the same objects and surfaces, like silverware, towels and railings.
Precautions that I take:
- Shower with Hibiclens (helps to get rid of staph bacteria on the skin) prior to surgery and continue until wound is completely healed.
- Be conscientious of what has been touched by others, food trays, blankets, pens, crutches, physical therapy equipment, etc.
- I’m not a germophobic but honestly you can’t wash your hands enough. Staff should always wash their hands (where you can see) prior to touching you or your items. If an item falls on the floor be aware that it is now contaminated by germs that hitchhiked on the soles of everyones shoes.
- Upon arrival home, I immediately shed any clothes that I had on at the hospital, wipe down my possessions and sponge bath with Hibiclens.
- Everyone becomes anxious to take a real shower after surgery, however, getting an incision wet "before the exterior incision is totally healed" puts you at great risk of infection.
I haven’t had any problems with infection since I began taking these precautions.
Wednesday, March 13, 2013
Wednesday, March 6, 2013
- Maheshwari A, Muro-Cacho C, Pitcher D. Pigmented villonodular bursitis/diffuse giant cell tumor of the pes anserine bursa: a report of two cases and review of the literature. Knee 14:402–407, 2007.
- Freedman BA, Lin DL, Tis JE. Pigmented villonodular synovitis of the calcaneocuboid joint in an 11-year-old child with subtalar coalition. Foot Ankle Int 28(4):511–515, 2007.
- Brenner JS. Pigmented villonodular synovitis causing painless chronic knee swelling in an adolescent. Clin Pediatr 46(3):268–271, 2007.
- Sekiya H, Ozawa H, Sugimoto N, Kariya Y, Hoshino Y. Pigmented villonodular synovitis of the elbow in a 6-year-old girl: a case report. J Orthop Surg (HongKong) 15(1):106–108, 2007.
- Mukhopadhyay K, Smith M, Hughes PM. Multifocal PVNS in a child–followed over 25 years. Skeletal Radiol 35:539–542, 2006.
- Tavangar SM, Ghafouri M. Multifocal pigmented villonodular synovitis in a child. Singapore Med J 46(4):193–195, 2005.
- Cussotti S, Ingrosso G, Parola PG, Mellano D, Linari A, Pucci A, Di Rosa G. Tendinous villonodular synovitis: a rare case of recurrence during childhood. Chir Organi Mov 89(2):167–170, 2004.
- Saulsbury FT. Pigmented villonodular synovitis of the knee in a 9-year-old child. South Med J 97(1):80–82, 2004.
- Eckhardt BP, Hernandez RJ. Pigmented villonodular synovitis: MR imaging in pediatric patients. Pediatr Radiol 12:943–947, 2004.
- Aydingoz V, Leblebicioglu G, Gedikoglu G, Atay O. Pigmented villonodular synovitis of the elbow in a 6-year old girl. J Shoulder Elbow Surg 11(3):274–277, 2002.
- Pill SG, Adams SB, Hubbard AM, Carpentieri DF, Dormans JP. Soft tissue mass of the second toe in an 11-year-old boy. Clin Orthop Relat Res 401:265–270, 2002.
- Bruecks AK, Macaulay RJ, Tong KA, Goplen G. Nov 2000: 13 year old girl with back pain and leg weakness. Brain Pathol 2:263–264, 2001.
- Rosenberg D, Kohler R, Chau E, Bouvier R, Pouillaude JM, David L. Pigmented villonodular synovitis. Diffuse and localized forms in children. Arch Pediatr 8 (4):381–384, 2001.
- Kaneko K, Nakahar D, Tobe M, Iwase H, Inoue Y, Ohbayashi O, Kurosawa H. Pigmented villonodular synovitis of the ankle in an adolescent. Int Orthop 23:234–237, 2000.
- Vedantam R, Strecker WB, Schoenecker PL, Salinas-Madrigal L. Polyarticular pigmented villonodular synovitis in a child. Clin Orthop Relat Res 348:208–211, 1998.
- Ganley TJ, De Ruiter CJ, Dormans JP, Meyer JS, Collins MH. Ankle pain and swelling in a 10-year-old girl. Clin Orthop Relat Res (348):282–284þ287–289, 1998.
- Hansen P, Nielson PT, Wahlin AB. Pigmented villonodular synovitis of the extensor tendon sheaths in a child. J Hand Surg Br 13(3):313–314, 1998.
- Hoeffel JC, Mainard L, Champigneulle J, Claudon M. Pigmented villonodular synovitis of the wrist in childhood. Clin Pediatr (Phila) 36(7):423–426, 1997.
- Minisola G, Porzio V, Ceralli F, Grillo LR, Porzio F. Polyarticular pigmented villonodular synovitis associated with multiple congenital anomalies: a case of noonan-like/ multiple giant cell lesion syndrome. Clin Exp Rheumatol 14(2):207– 210, 1996.
- Kay RM, Eckardt JJ, Mirra JM. Multifocal pigmented villonodular synovitis in a child: a case report. Clin Orthop Relat Res 322:194–197, 1996.
- Meehan PL, Deftari T. Pigmented villonodular synovitis presenting as a popliteal cyst in a child. J Bone Joint Surg Am 76(4):593–595, 1994.
- Kang GH, Chi JG, Choi IH. Pigmented villonodular synovitis in the sacral joint with extensive bone destruction in a child. Pediatr Pathol 12:725–730, 1992.
- Soifer T, Guirguis S, Vigorita VJ, Bryk E. Pigmented villonodular synovitis in a child. J Pediatr Surg 28(2):1597–1600, 1993.
- Curtin WA, Lahoti OP, Fogarty EE, Dowling FE, Regan BF. Pigmented villonodular synovitis arising from the sheath of the extensor hallucis longus in an eight-month-old infant. Clin Orthop Relat Res 292:282–284, 1993.
- Bruns J, Schubert T, Eggers-Stroeder G. Pigmented villonodular synovitis in children. Arch Orthop Trauma Surg 112(3):148–151, 1993.
- Green A, Sutherland W, Trafton PG. Localized nodular synovitis of the ankle: a case report. Foot Ankle 12(1):47–51, 1991.
- Givon U, Granel A, Heim M. Pigmented villonodular synovitis. Arch Dis Child 66:1449–1450, 1991.
- Matejicek M, Dungle, Trnka V, Havelka S, Hoza J. Multiocular pigmented villo- nodular synovitis in a child: a case report. Acta Universitatis Medica 37(1-2):31–36, 1991.
- Aghasi MK, Robinson D, Reif RM, Halperin N. Pigmented villonodular synovitis of the talus in a child. Foot Ankle 9(3):139–142, 1988.
- Wendt RG, Wolfe F, McQueen D. Polyarticular pigmented villonodular synovitis in children: Evidence for a genetic contribution. J Rheumatol 13(5):921–926, 1986.
- Walls JP, Nogi J. Multifocal pigmented villonodular synovitis in a child. J Pediatr Orthop 5:229–231, 1985.
- Wagner ML, Spjut HJ, Dutton RV. Polyarticular pigmented villonodular synovitis. AJR 136(4):821–823, 1981.
- Lindenbaum BL, Hunt T. An unusual presentation of pigmented villonodular synovitis. Clin Orthop Relat Res 122:263–267, 1977.
- Leszczynski J, Huckell JR, Percy JS, LeRiche JC, Lentle BC. Pigmented villonodular synovitis in multiple joints: occurrence in a child with cavernous haemangioma of hip and pulmonary stenosis. Ann Rheum Dis 34:269–272, 1975.
- Bobechko WP, Kostuik JP. Childhood villonodular synovitis. Can J Surg 11:480–486, 1968
Saturday, February 23, 2013
Newly diagnosed 11/2011via mri, Game Plan: Begin with arthroscope to confirm via intra operative biopsy, extensiveness of pvns determined they had to revert to an open syno.
Friday, January 18, 2013
Fortunately, I was able to schedule an arthroscopic procedure with the same surgeon exactly one year to the date of my first pvns surgery. This time I had to have surgery in a different hospital and I wasn't comfortable with my surroundings. This particular hospital had the look and feel of an inner city hospital on the wrong side of town...if you know what I mean. My admittance to the presurgical area seemed to be rushed even though it was thorough, which made me feel uncomfortable. However, my confidence in the hospital continued to diminish when the nurse couldn't get an IV started and started freaking out about it. The upside to this is that my IV was started in the surgical suite and the block was given after I was already unconscious. Unknowing at the time having the block administered after I was asleep increases my chances for possible nerve damage. Fortunately I was fine but would have liked to have known.
In recovery I was given morphine and my arm turned red and itchy. Not a true allergy only a sensitivity so I was given benedryl. Within 5 minutes I'm asked if I'm ready to sit in a chair. "well I guess so." So they transferred me to stage two, but I wasn't in stage 2 for over 5 minutes when they are asking if I'm ready to go home. Try to understand I'm drugged and well home sounds good. The nurse hands my husband some papers and asked if she needed to call transportation or if I could walk. I just had knee surgery but what the heck. So we are on the way home and I realize the nurse never gave any verbal instructions and I didn't have a clue as to what I needed to do for follow up. Folks this is not what you want to experience from a hospital stay. Thankfully it was just an outpatient procedure but this is why it is important to check out the hospital and make sure you are comfortable with it.
While I was in stage 2 recovery my husband notified me that there was good and bad news. "Bad news?" Nope I don't want to here any bad news. "I'll take the good news first." Thankfully, the suspected recurrence of pvns turned out to be scar tissue. Finally, I catch a break with this dreaded disease. Then "the hammer" shatters my good fortune. In a hesitant voice my husband informs me that I need a knee replacement and they could do it in about 6 weeks. Yikes! More surgery is not what you want to here when you are just waking up from a surgery.
Well it has taken me a couple weeks to wrap my head around needing a knee replacement. I'm only 48 and the thought of a total knee replacement is terrifying. I figure knowledge is power, right? So I went on utube and watched several TKR videos and was cringing the entire time. Now I had a few questions for my surgeon so I made an appointment. After a couple more weeks and much research I finally saw my surgeon. Long story short she feels that I may be a good candidate for a uni-compartmental replacement/resurfacing which is a fancy description of a partial replacement. So I make an appointment with an orthopedic surgeon who specializes in this technique and waited 2 more weeks which just gave me more time to do additional research on partial replacements. Well, what I was finding in the literature was not promising and quite frankly discouraging for the long term success of this technique.
Finally the day has come to get some questions answered from my possible new surgeon. First of all I had a list a questions that I presented. I don't ask non pertinent or stupid questions so this is the way that I test the surgeons personality, preparation, skill and experience. All of these traits and aspects are very important to me. I was impressed and it's not easy to impress me. He prepared for my appointment and thoroughly knew my case, had already read all of the reports prior to my arrival. The only thing that he needed to see was the photos that were taken of my knee at the time of my last surgery...which I brought with me. He thoroughly in a non rushed manner answered every last question.
Long story short he presented a couple different options. #1 He could put plugs of cartilage in my knee, do a Patello Femoral Resurfacing, or go back to my pvns surgeon for a total replacement. As we discussed what role the pvns could play in the different choices we both agreed that cartilage transplant probably would not be the best way to go. I told him of my aprehension of a partial replacement due to the recent studies. He informed me the studies reflected the old hardware and patient selection guidelines. The problem have been identified and they corrected the design flaws in the hardware and the short term reviews are wonderful but obviously there aren't any long term studies yet.
He is confident that the resurfacing (partial replacement) would buy me some time and that it would be a better choice instead of a full replacement since the damage was confined to the patello femoral area. So I will be having a resurfacing in a couple weeks. I also learn about many other procedures and even up and coming bio joint replacements. Yup, they have grown new joints for animals. The links are in the side bar of the home page. Immediately after this appointment I went across the street and checked out the hospital to see if I felt comfortable, talk with workers and pick up information about the hospital.