Pigmented villonodular synovitis (PVNS) is a slowly progressive lesion that originates from the synovial membrane of the tendons and joints. There are two forms of PVNS: localized and diffuse. DP VNS is a rare proliferative tumor of synovial tissue involving the entire synovium of joint, and it is also a difficult tumor to eradicate. Treatment options include arthroscopic synovectomy, open synovectomy, partial synovectomy combined with radiation or chemotherapy, and arthrodesis or total joint replacement. Success rates varied in the above treatments and high recurrent rates, 30% in average, were reported. Complete resection of all pigmented villonodular tissue appeared to be the key to preventing recurrence of the condition. The patient had received complete resection of pigmented villonodular tissue combined with anterior and posterior approach. No tumor recurrence was noted during the 6 years post-surgery follow-up period.