International Orthopaedics

, Volume 37, Issue 6, pp 1165–1170 | Cite as

Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints)

  • Xiaomei MaEmail author
  • Guodong Shi
  • Chunyan Xia
  • Huimin Liu
  • Jin He
  • Wentao Jin
Original Paper



Pigmented villonodular synovitis (PVNS) is a relatively rare, benign proliferation lesion of the synovium of large joints, but there is not much information available about the disease’s aetiology, clinical history, differential diagnosis, treatment, and long-term effects. We conducted a study to analyse these aspects of PVNS.


We reviewed all clinical data for 75 patients with PVNS (81 joints) who were treated either by synovectomy alone or synovectomy plus arthroplasty.


In all cases, the diagnosis of PVNS was confirmed by pathological examination. The ratio of males to females was 27:48, and the average age of patients was 46 years (range, 15–80 years). Lesions were located in the knee, hip, or ankle, and pain and swelling were the main symptoms. Of 75 patients, 42 had a history of trauma to the involved joint. Forty-one patients (43 joints) underwent synovectomy alone, and 34 patients (38 joints) underwent synovectomy and arthroplasty together. Of the 75 patients, 61 had full follow-up data. Twelve patients had recurrent legions detected by pathological examinations; four patients had more than two recurrences. Moreover, five patients developed PVNS after arthroplasty.


PVNS occurs most often in middle-aged women and most frequently involves the knee, followed by the hip and ankle. The disease’s etiology is varied and unclear. Surgical excision alone or with arthroplasty is an effective treatment, but there is a high rate of recurrence.


Magnetic Resonance Imaging Chronic Myeloid Leukemia Bone Erosion Pigment Villonodular Synovitis Arthroscopic Synovectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Medical editor Katharine O’Moore-Klopf, ELS (East Setauket, NY, USA) provided professional English-language editing of this article.

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.


  1. 1.
    Ottaviani S, Ayral X, Dougados M, Gossec L (2011) Pigmented villonodular synovitis: a retrospective single-center study of 122 cases and review of the literature. Semin Arthritis Rheum 40:539–546PubMedCrossRefGoogle Scholar
  2. 2.
    Botez P, Sirbu PD, Grierosu C, Mihailescu D, Savin L, et al. (2013) Adult multifocal pigmented villonodular synovitis—clinical review. Int Orthop Jan 30 [Epub ahead of print]. doi: 10.1007/s00264-013-1789-5
  3. 3.
    Ma X, Xia C, Wang L, Zhao L, Liu H et al (2011) An unusual case of pigmented villonodular synovitis 14 years after total hip arthroplasty. J Arthroplasty 26:339e5–339e6CrossRefGoogle Scholar
  4. 4.
    Wong JJ, Phal PM, Wiesenfeld D (2012) Pigmented villonodular synovitis of the temporomandibular joint: a radiologic diagnosis and case report. J Oral Maxillofac Surg 70:126–134PubMedCrossRefGoogle Scholar
  5. 5.
    Rao AS, Vigorita VJ (1984) Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane): a review of eighty-one cases. J Bone Joint Surg Am 66:76–94PubMedGoogle Scholar
  6. 6.
    Bunting D, Kampa R, Pattison R (2007) An unusual case of pigmented villonodular synovitis after total knee arthroplasty. J Arthroplasty 22:1229–1231PubMedCrossRefGoogle Scholar
  7. 7.
    Bhimani MA, Wenz JF, Frassica FJ (2001) Pigmented villonodular synovitis: keys to early diagnosis. Clin Orthop Relat Res 366:197–202CrossRefGoogle Scholar
  8. 8.
    Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ et al (2008) Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 28:1493–1518PubMedCrossRefGoogle Scholar
  9. 9.
    Cupp JS, Miller MA, Montgomery KD, Nielsen TO, O’Connell JX et al (2007) Translocation and expression of CSF1 in pigmented villonodular synovitis, tenosynovial giant cell tumor, rheumatoid arthritis and other reactive synovitides. Am J Surg Pathol 31:970–976PubMedCrossRefGoogle Scholar
  10. 10.
    Loriaut P, Djian P, Boyer T, Bonvarlet JP, Delin C et al (2012) Arthroscopic treatment of localized pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc 20:1550–1553PubMedCrossRefGoogle Scholar
  11. 11.
    Vastel L, Lambert P, De Pinieux G, Charrois O, Kerboull M et al (2005) Surgical treatment of pigmented villonodular synovitis of the hip. J Bone Joint Surg Am 87A:1019–1024CrossRefGoogle Scholar
  12. 12.
    Brien EW, Sacoman DM, Mirra JM (2004) Pigmented villonodular synovitis of the foot and ankle. Foot Ankle Int 25:908–913PubMedGoogle Scholar
  13. 13.
    Yoon HJ, Cho YA, Lee JI, Hong SP, Hong SD (2011) Malignant pigmented villonodular synovitis of the temporomandibular joint with lung metastasis: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:e30–36PubMedCrossRefGoogle Scholar
  14. 14.
    Cassier PA, Gelderblom H, Stacchiotti S, Thomas D, Maki RG et al (2012) Efficacy of imatinib mesylate for the treatment of locally advanced and/or metastatic tenosynovial giant cell tumor/pigmented villonodular synovitis. Cancer 118:1649–1655PubMedCrossRefGoogle Scholar
  15. 15.
    Fiocco U, Sfriso P, Oliviero F, Sovran F, Scagliori E et al (2006) Intra-articular treatment with the TNF-alpha antagonist, etanercept, in severe diffuse pigmented villonodular synovitis of the knee. [Article in Italian]. Reumatismo 58:268–274PubMedGoogle Scholar
  16. 16.
    Chin KR, Barr SJ, Winalski C, Zurakowski D, Brick GW (2002) Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee. J Bone Joint Surg Am 84A:2192–2202Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Xiaomei Ma
    • 1
    Email author
  • Guodong Shi
    • 2
  • Chunyan Xia
    • 1
  • Huimin Liu
    • 1
  • Jin He
    • 1
  • Wentao Jin
    • 3
  1. 1.Department of Pathology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  2. 2.Department of Osteology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  3. 3.Department of Radiology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina

Personalised recommendations