Abstract: Objective ： To evaluate the long -term results of limb salvage surgery combined with postoperative adjuvant chemotherapy in primary osteosarcoma cases. Methods ： Between 1985 and 1999, 70 patients aging from 11 to 55 years with the diagnosis of Ⅱb extremity osteosarcoma were treated with definitive surgery and adjuvant chemotherapy regimens. Among them, 50 cases were of limb salvage procedures by wide or radical resections, which included devitalized tumor bone reimplantation in 25 cases, endoprosthestic replacement in 12 cases, osteoarticular allograft implantation in 9 cases,and vascularized fibula autograft implantation in 4 cases. Amputations were performed in 29 cases. The patients were followed-up for 3)17 years (mean nine years and five months). Results ： There were no statistically differences in disease-free survival (DFS) rate and local recurrence rate between limb salvage group and amputation group. The patients' DFS rate and recurrence rate of various limb salvage procedures were remarkable, but there were no statistical evidence due to small amount of cases. The complications of limb salvage surgery were composed of infection, fracture, nonunion and prosthesis loosing. The complication rate was much higher in procedures of devitalized tumor bone reimplantation than others. Conclusion : Endoprosthestic replacement is the best choice of limb salvage surgery in osteosarcoma cases. The postoperative complication should be particularly cautioned in terms of devitalized tumor bone reimplantation and allograft implantation.