Wide resection of bone tumour has become an accepted treatment in the limb salvage surgery. The reconstruction of the residual defect following wide resection is a major problem. Author had reviewed the results of five reconstruction methods. Osteoarticular graft is suitable for proximal tibial reconstruction and endoprosthesis for distal femoral reconstruction. Autograft is rarely used to reconstruct the large residual defect. Cement can reconstruct the larger defect, but it is not a suitable procedure on long term basis.

Health technology has been defined by WHO as the set of techniques, drugs, equipment and procedure used by health care professionals in delivering medical care to individuals and the system within which such care is delivered. Health technology assessment includes analyses of safety, efficacy and effectiveness, cost and cost effectiveness, infrastructure factors, social impact and fit, needs and capabilities of local health care delivery system.

The reimplanatation of resected autoclaved tumour bone graft is technically a simple, financially a cost saving and a biological solution for this difficult problem. This method of reconstruction fulfills all criteria of health technology. It is the suitable method of reconstruction in limb salvage surgery for all countries, but most suitable for the developing and poor countries where the resources for other methods are not available due to financial, technical or socio-cultural reasons.

Between 1955 and 1989 we treated 24 patients (17 women and seven men) with giant-cell tumours of the spine at the Mayo Clinic. Their mean age was 30 years and the mean follow-up time was 12.4 years. Pain was the presenting symptom in all and half had a neurological deficit. The cervical, thoracic, and lumbar spines were equally involved. The tumours recurred in five of the 14 patients treated by one-stage surgery and in five of the ten treated by two-stage surgery. Seven patients received adjuvant radiotherapy, one for the primary lesion and six for recurrent lesions. Surgical management was by curettage or en bloc excision depending on the location and the extent of the tumour. Because of the risk of sarcomatous transformation, radiation therapy should be reserved for patients with incomplete excision or for those with local recurrence.