Introduction: Limb salvage surgery is the adopted approach for managing bone sarcomas and aggressive bone tumors. In different literature, the outcome has varied based on the surgical approach and expertise of the surgical team. In this paper, we will discuss the outcome of limb salvage surgery in a single center where all cases were operated upon by the same surgeon.

Methods: Two hundred forty four patients with malignant bone tumors were referred to KHCC, Thirty-four of the patients were found ineligible for limb salvage surgery and received primary amputation. The remaining 210 patients received limb salvage surgery. In 193 patients (92.4%), endoprostheses (Modular type, Joint sparing and expandable) were used for reconstruction of the skeletal defects.

After a mean follow up period of 6 years (1-14.5 years) the following variables were reviewed; limb salvage rate for all patients, oncological outcome (negative margin and local control), surgery related complications, prosthesis and limb survival, and functional outcome.

Results: Limb salvage was performed in 210 patients out of a total of 244 (86%). Negative resection margins were achieved in 204 patients (97%). Local control was achieved in 178 patients (85%), local recurrence in 32 patients, and 14 of them developed systemic metastasis. One hundred fifty-six patients (74%) did not develop any complications and received only the primary surgery. There was no significant difference between the 3 main subtypes of implants regarding medium and long term survival (p = 0.5).The mean functional score using the modified musculoskeletal tumor society score (MSTS) was 90% for all anatomical locations.

Conclusion: This study shows the rewarding outcome of limb salvage surgery in terms of oncological, functional and complication free course, for the same cohort of patients over a long term follow up period.