Aims: The knee is the commonest articular location in osteosarcoma (OS). We study the complications in limb salvage due to OS in knee reconstructions.

Methods: In our series of 107 OS for the period 1983–1998, limb salvage procedure was possible in 78 cases and the amputation was necessary in 29 patients. The Knee reconstruction includes 62 cases (39 due to femur OS and 23 due to tibia OS). All cases were treated with preoperative and postoperative chemotherapy. The average follow-up was 87.4 months with a range of 55 to 183 months.

Results: Complications in re-constructions due to femur OS:

– Local recurrence 2/39 (5.13%)

– Infection 2/39 (5.13%)

– Fatigue fracture (7.6%) Complications in tibia re-constructions:

– Local recurrences 3/23 (13%)

– Infection 5/23 (21.7%)

Patellar tendon tear off 2/23 (8.7%)

Fatigue fracture 1/23 (4.35%).

Conclusions: The rate of complications in tibia is higher than in femur.

The infections in tibia limb salvage are related to skin coverage.

The local recurrence in tibia is related to anatomical problems to achieve wide resections