A 20-year-old male patient with osteosarcoma in left distal femur was treated with alcohol-inactivated autograft replantation with articulation preservation. a Preoperative MRI showed intramedullary low mixed signal in T1 in distal femur. The lowest boarding of tumor lies 2cm over Insall line which was classified as Type I. b-d Postoperative X-ray at 1 week, 3 months and 6 months. e and f 16 months and 20 monthes after operation, X-ray showed bone callus in diaphysis, and bony healing in conjunction between host bone and inactivated bone. g 35 months after operation, X-ray showed fully bony healing and good joint space. At the end of follow-up, he has returned to normal work with 33 in MSTS score and 53 in QOL.