Pigmented villonodular synovitis (PVNS) is a benign process that mainly affects the knee joint. There are two types of PVNS, a localised and a diffuse form. Although adjuvant therapies are possible, the treatment consists of arthroscopic or open synovectomy of the affected area. The most common complication is local recurrence. We report the case of a patient with PVNS and osteolysis of the femoral condyle, treated with anterior arthroscopic synovectomy and posterior approach for the treatment of the femoral condyle erosion. The bone erosion was treated with polymethylmethacrylate (PMMA) cement. There are no publications indexed in our knowledge that explain the treatment of PVNS associated with bone erosion by PMMA. Nine years after the procedure, the patient is leading a fully active life with no evidence of active disease.