The Journal of Bone and Joint Surgery (American). 2005;87:1019-1024.
doi:10.2106/JBJS.C.01297
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Surgical Treatment of Pigmented Villonodular Synovitis of the Hip

Laurent Vastel, MD1, Patrick Lambert, MD1, Gonzague De Pinieux, MD1, Olivier Charrois, MD1, Marcel Kerboull, MD1 and Jean-Pierre Courpied, MD1

1 Departments of Orthopaedic Surgery (L.V., P.L., O.C., M.K., and J.-P.C.) and Pathology (G.DeP.), Cochin-St. Vincent de Paul Hospital, Paris V University, Pavillon Ollier, 27 rue du Faubourg St. Jacques, 75014 Paris, France. E-mail address for L. Vastel: laurent.vastel{at}cch.ap-hop-paris.fr

Investigation performed at Cochin University Hospital, Paris, France

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Pigmented villonodular synovitis of the hip is a rare disease. Synovectomy is generally accepted as the only surgical treatment for the disorder, but there have been few studies with a sufficient sample size and duration of follow-up to allow the evaluation of long-term outcomes. The aim of this study was to determine the long-term outcome of the treatment in sixteen patients.

Methods: Sixteen patients (nine men and seven women), with a mean age of 35.5 years at the time of surgery, were treated between 1970 and 1996. Complete synovectomy was performed in all patients; in addition, three had a cup arthroplasty, four had a total hip arthroplasty, and one had a monopolar arthroplasty. Clinical and radiographic outcomes were evaluated retrospectively at a mean of 16.7 years postoperatively. Only one patient was followed for less than eight years.

Results: Nine patients needed repeat surgery, but only one had recurrent synovitis, as detected with pathological examination fourteen years after treatment with synovectomy and cup arthroplasty. Secondary osteoarthritis developed in all eight patients who had been treated with synovectomy alone, and four of them required a total hip arthroplasty within the follow-up period.

Conclusions: These results support earlier data indicating that osteoarthritis consistently develops in patients with pigmented villonodular synovitis of the hip. Complete synovectomy seems to be effective in preventing recurrence of the synovitis, but it does not appear to prevent the development of secondary osteoarthritis.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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