Background: Primary bone sarcomas typically arise in the long bones and the pelvis of children and adolescence but may also occur in adults. Meta/diaphysial tumour involvement resulting in the necessity of a joint replacement is more common than diaphysial tumour sites.
Aim: In the treatment of these tumours, both endoprosthetic replacement and biological reconstruction techniques are used. Each technique has method-specific advantages and disadvantages.
Results: To choose the appropriate surgical method, a multitude of influencing parameters need to be considered. The age at treatment (soft tissue situation/estimated growth/biological potential of the bone), therapeutic concept (palliative vs. curative), the tumour site (upper/lower extremity), tumour expansion (diaphysis/metaphysis) and oncological treatment concept (chemotherapy/radiotherapy) are key factors significantly influencing the surgical technique in terms of functional outcome and longevity of the reconstruction.
Conclusion: Surgical treatment of bone sarcoma requires broad-based experience of the oncological surgeon. Knowledge of the different surgical technics and reconstruction methods is decisive to offer the individual patient the best oncological and functional outcome.