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To investigate the clinical characteristics of pigmented villonodular synovitis of the hip and its appropriate treatment modalities. We retrospectively analyzed the clinical symptoms and signs, laboratory data, radiologic findings and methods and results of treatment of 4 patients of which the diagnosis was confirmed microscopically. The most common complaints was pain and a palpable mass was combined in one case. The limitation of joint motion was present in 3 cases and laboratory data were normal in all cases. On plain films, a classic form with large and multiple lucencies was found in 2 cases and a osteoarthritis-like form was found in 2 cases. The operative treatment was performed in all cases. In one case, there was no evidence of recurrent disease at 20 months after synovectomy alone. In 2 cases, patients were treated with total hip replacement combined with synovectomy and there were no evidence of recurrent disease at 27 months and 36 months each other. In one case, the patient had a recurrence at 7 years and 6 months after synovectomy alone and underwent total hip arthroplasty combined with synovectomy. At 4 years and 1 month after reoperation, this patient had a local recurrence and underwent curettage and bone graft. The early diagnosis and treatment of pigmented villonodular synovitis will prevent the further destruction of the hip and the thorough synovectomy will decrease the recurrent rate.
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