My wife has been diagnosed with having this in her knee, and has been
scoped 3 times and had major sugery on it once.  Each time, the doctor
had supposedly removed all the necessary tissue, but each time it has
come back.  Is there any treatment that can take care of this?  Or is
this condition one of those black holes of medicine where there is no
known cure and research is being done but nothing ever comes of it?

It seems to me that the only treatment to truly get rid of this is
completely removing the synovial tissue, and the only way to do it
is to have knee replacement surgery.  But then again, I'm a software
designer, not a doctor (apologies to Dr. McCoy).

Anyone have any info on this ailment?

Thanks,
Brian (expert knee massager)

Pigmented villonodular tenosynovitis is a response to trauma and I have
seen it many times as a specimen from surgery. Sometimes it is florid.
Sometimes very minimal. It is associated with ostoarthritis or overuse
arthritis. As a non-treating physician, I can only guess that people would
try things such as steroids and methotrexate, and maybe, sometimes, if
very troublesome, with radiation therapy.  It is pigmented because of
broken red cells in the synovial space and their withdrawal by
histiocytes. The pigment is hemosiderin. A good orthopod should be able to
handle this. Be sure it is not something else, like osteochondromatosis.
Bill Palmer, MD

--
William Palmer
Anatomic Pathology Institute
Oakland, CA 94618