Diffuse pigmented villonodular synovitis of the foot and ankle treated with surgery and radiotherapy

We followed up seven patients with histologically confirmed diffuse pigmented villonodular synovitis in a prospective study between 1992 ans 2001. The mean age at diagnosis was 30.7 years. The patients underwent synovectomy, followed by radiotherapy with a total dose of 35 Gy in 20 fractions. In all cases, the excision was considered incomplete when examined histologically. At an average follow up of 24 (18-36) months, six patients reported better function and reduced levels of pain. One patient remained symptomatic but did not have a recurrence. We conclude that a combined approach to a primary pigmented villonodular synovitis of the foot and ankle may reduce the risk of recurrence without functional impairment.