PVNS Radiation, Recurrence Update

Stats on external radiation are looking good and decreasing recurrance to 15-20% vs 45% in diffuse pvns. That is why an increasing amount of physicians are utilizing it early on in pvns treatment. We know from the stats on malignant tumors the area that the radiation actually dose hits will sterilize the cells so they can't reproduce, but then again treatment is only as good as the mapping and dosage which is not only a science but an art. Radiation does not come without it's own risks and consequences. 

In my case I over healed and had to be knocked out again for a manipulation to break up the adhesions. It now feels like there is a tight band around my knee and it stiffens easily. In all fairness you can get the same thing from just having an open synovectomy like I had, so I'm not sure how I would feel if I didn't have radiation. Radiation also increases recovery time, for me it was 6 weeks before I had my normal energy level and it did add onto physical therapy time. The tab for my RT was $26,000 thank goodness for insurance but I still had copays.

The surgeon and I again discussed that it was a right decision to get RT in my case since it was diffuse throughout my knee combined with my past medical history. They removed all pvns that showed in the mri and all that was visible, but it's impossible to get out the microscopic cells. Unfortunately it looks like there are now new areas of pvns. She isn't convinced that it is pvns on the tendons and if it is the only thing that they could do is graft a new tendon into the knee which would cause more problems then the pvns at this stage. Another new area that it is showing is almost into the muscle which it won't damage the joint. There are other areas that are probably pvns and time will tell. My joint is still good but in my case it looks like the pvns may acting very very aggressive.  So yes RT was a wise decision in my case. My next mri is in 3 months. Hind site is 20/20. The dice could have just as easily rolled the opposite way and I would never know if I caused unnecessary damage to my knee. Everything is a roll of the dice when making treatment decisions about pvns. Remember certain effects from radiation and chemo can not be reversed.

Update: 08/2014 I'm now approaching three years of being PVNS Free. 


(During 12/14/2012 surgery discovered pvns had not recurred and the mri was showing scar tissue)

I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.