Limb salvage surgery for primary malignant bone tumors of the lower limbs requires complete resection of the tumor, followed by a reconstruction to restore function. In contrast to the abundant information on total knee arthroplasty, data on the recovery pattern of limb salvage surgery is largely limited. With the aim of guiding patient expectations and optimizing care, we retrospectively compared the clinical outcomes among patients following oncologic knee reconstruction, primary total knee arthroplasty, and revision total knee arthroplasty. From January, 2001 to June, 2009, we identified a cohort of 503 primary total knee arthroplasties, 55 revision knee arthroplasties, and 15 oncologic reconstructions. Outcomes were assessed by the validated Short Form-36 (SF-36) health questionnaire. We found that oncologic patients significantly improved their Physical Component Score at one and minimum two-year follow up compared to baseline (p< 0.05) with the majority of improvement (90%) made within the first year following surgery. This is a similar pattern to that observed following primary and revision total knee arthroplasty.