I spoke with my surgeon the day after surgery. She informed me that she began surgery arthroscopically and took an open biopsy, frozen section. This confirmed that I have PVNS. We had discussed prior to surgery that if PVNS was confirmed that she would revert to an open anterior synovectomy in order to have the best access to the joint for cleaning it out. It was also quite obvious from all of the hemosiderin displayed as a brown covering over my cartilage that I have the diffuse PVNS. Fun Facts: It is possible to differentiate nodular from diffuse pvns by their unique cellular structure.
My surgeon said that she cut out all of the pvns that she could see and that showed on the mri, however, it’s impossible to say you removed it all out because then you are talking about on a cellular level. Hence the reason to think about using radiation therapy to kill the remaining cellular bits. Personally, I will be speaking with a radiology oncologist after my 2 week check up to see what they advise in my case.
My PVNS was primarily located in the anterior compartments and under the patella. I have overall stage 2 chondromalacia on a scale of 1-5 (rather mild cartilage damage). She said the cartilage under my patella was looking rough. while in my knee she also repaired my torn meniscus. As far as the bakers cyst is concerned they don’t go after them because you risk nerve damage and the cyst should go away on it’s own since the torn meniscus and pvns has been taken care of. She would like to follow up with an mri in 6 months to check on the state of my knee at that point. Long term follow up care will be determined based on the 6 month report and any future symptomology.
I hope that it won’t come back... but knowing that I have done everything possible to decrease my chances of it returning will have to be my peace of mind. The next step will begin with physical therapy.
Stats for today: I’m feeling better then I have since surgery. Post-Op day 7, Pain scale 2-3 and I’ve been able to reduce my break through oxycodone to 1x daily. More bruising is becoming apparent but my incision is healing nicely. I’ve been doing my prescribed exercises, ice, elevation. I’m able to just use one crutch if I’m cautious. I prefer to use both crutches so that I can concentrate on doing the full movement of a step (I’m not there yet). My doctor told me that I could move it and out as much weight on it as tolerated without causing an increase in pain. Please don’t do anything that hasn’t been cleared by your doctor. I have more energy today but have to be cautious not to over exert myself. Every day I’m getting a slight bit more movement but very far from normal. I work behind a desk and I’m not physically ready to return to work yet.
I decided not to get a shower seat and change to a hand held shower head. Psychologically it’s healthier for me just to wash my hair in the kitchen sink and do a sponge bath then to see special equipment in my bathroom. I was forced to depend on special equipment with a previous injury and it just has too many memories for me. I’ll expound on this subject on an upcoming post.
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