Pigmented Villonodular Synovitis (PVNS) is a benign (non-cancerous) condition that occurs due to overgrowth of the synovium, the tissues that line the joints, or production of excess synovial fluid. A majority of PVNS cases occur in the knee. Treatment of PVNS commonly includes a synovectomy to remove the excess tissue and fluid.
Pigmented Villonodular Synovitis (PVNS) is a benign (non-cancerous) condition that occurs due to overgrowth of the synovium, the tissues that line the joints, or production of excess synovial fluid. PVNS can be localized, where only a portion of the joint is affected, or diffused, where the condition is more widespread and involves the entire joint. While PVNS can affect any joint, it most commonly affects the knee and presents with pain, swelling, and stiffness. Without treatment, it can continue to grow and cause arthritis, tendon or joint damage.
Pigmented Villonodular Synovitis (PVNS) is a non-cancerous condition that occurs due to overgrowth of the synovium, the tissues that line the joints, or production of excess synovial fluid. The risks associated with PVNS include invasion and destruction of the neighboring bone, destruction of cartilage, extension beyond the joint into adjacent nearby tissue, arthritis, and in very rare circumstances can become malignant.
Radiographic imaging is used to help form a diagnosis of PVNS. These include X-Ray, MRI, CT and Bone Scans.
An example of an MRI is shown.
The treatment of pigmented villonodular synovitis (PVNS) varies depending on the location and severity of the condition. Treatment options typically include open synovectomy, arthroscopic synovectomy, combined arthroscopic/open synovectomy, and joint excision/replacement. Specifically, for diffuse PVNS which is associated with high recurrence rates, treatment includes an open synovectomy. There are more limited treatment options for local PVNS, however an arthroscopy partial synovectomy may be performed. Radiation may also be considered in conjunction with surgery, which can help with local control.
An open synovectomy is a surgical procedure, in which an incision is made to the affected joint and the excess synovium causing PVNS is surgically removed. On the other hand, an arthroscopic synovectomy is a minimally invasive surgery which uses an arthroscope and makes small incisions to remove the excess synovium. Synovectomies are procedures to treat PVNS and can be performed as an open synovectomy, arthroscopic synovectomy, or combination of both.
Radiation is a treatment option for some cancers. Radiation therapy is a localized treatment that utilizes high-energy particles or waves to kill cancerous cells. Because radiation therapy is a localized treatment, it only affects the area in which it is set to target and therefore eliminates the risks of damaging healthy cells throughout the body. Not only is it used to treat cancer, but it can also decrease the chances of the cancer from recurring. Lastly, radiation may be used in conjunction with other treatments, such as surgery or chemotherapy, to treat cancers.
I've seen many doctors and I can confidently attest Dr. Wittig is the preeminent orthopaedic specialist. He is genuinely kind and caring, as he demonstrated by completely addressing my concerns and compassionately relating to what I was dealing with. He clearly outlined the plan of attack, and recommended the two additional doctors who would become part of my 'team'. Dr. Wittig was so effective in allaying our fears and bringing us optimism. My surgery was significant, but I was up and walking the next day and back at the gym 5 weeks later. This is further testament to Dr. Wittig's skill. He saved my leg and my life, and I feel so very blessed to say he is my doctor. I have already recommended him to others, and I will continue to do so. I would trust him with my closest family and lifelong friends. BEST DOCTOR EVER.
Myself and my amazing team are dedicated to saving your life and your limb. Losing a limb because of a tumor can be a terrifying experience. But, it does not have to be the only option. I’ve spent 20+ years as a Board-Certified Orthopedic Surgeon and Orthopedic Oncologist.
I’ve devoted my career to helping children and adults afflicted with bone and soft tissue masses by performing complex limb saving surgeries. Most patients can have their limb saved, which may require innovative techniques.
Patients afflicted with musculoskeletal tumors have complex conditions that are best taken care of at large hospitals. I am the Chairman of Orthopedics and Chief of Orthopedic Oncology at Morristown Medical Center. My philosophy is a multidisciplinary team approach, working together to tailor treatment to individual patients. Education and research are essential to my practice, providing the best setting for extraordinary patient care. Because of this, we have some of the top results in the country.