Bone sarcomas of the lower extremities are rare malignancies with an incidence of 0.8, thus representing 0.2% of all malignant tumors [1,2]. The tumor specific distribution of the age when patients present to a physician is mostly in the adolescence and young adult age group. The most common bone sarcomas are osteosarcoma, Ewing-sarcoma and chondrosarcoma—with an overall incidence of 0.3, 0.3 and 0.2 respectively [[1], [2], [3]]. Although, osteosarcoma presents in adolescents with a higher incidence (0.8–1.1 at age 15–19 years) [4,5], chondrosarcoma is most frequent in adulthood [[4], [5], [6]], and Ewing-sarcoma occurs more frequently in children and adolescents but is also observed in adults [2,[4], [5], [6]]. As the primary therapy is multidisciplinary and multimodal; these patients have to be treated in a sarcoma center—mostly requiring radical resection following a neoadjuvant radio-chemotherapy in the case of radio- and chemosensitive neoplasms. The radical resection can be performed through two types of surgical approaches: either limb salvage or amputation, both of which consists of a number of techniques known to retain or recreate the function of the lower limb. In the case of an amputation, an exoprosthesis with or without rotationsplasty or an endo-exoprosthesis can be used. In the case of limb savage, biological or prosthetic reconstruction procedures or a composite thereof may be used [7,8]. Since the end of the 20th century limb salvage has become the standard therapeutic procedure through the use of an improved diagnostic algorithm and multimodal therapy—including improved chemotherapy with complex surgical opportunities for reconstruction [1,[8], [9], [10]]. Previous studies have shown that overall survival is similar after both limb salvage and after amputation [3,8,11,12]. In these rare primary malignancies of the skeleton of the lower extremity, limb retention is the method of choice whenever possible [9,10,13,14]. In a metastasis free situation, the survival rate can reach over 90% depending on tumor characteristics and other prognostic factors [9,10]. The overall survival rate at 5-years, including cases with metastasis, is approximately 70–80% [10,11,15,16].