A 15-year-old female patient with osteosarcoma in right distal femur was treated with alcohol-inactivated autograft replantation with articulation preservation. a. Preoperative MRI showed intramedullary high and low mixed signal in distal femur. The tumor lies near Insall line which was classified as Type II. b. Preoperative X-ray showed osteolytic bone destruction in distal femur, in accompany with severe bone destruction in lateral cortical bone, local soft tissue mass and periosteal reaction. c. Postoperative X-ray showed significantly reduced osteolytic bone destruction in distal femur, in accompany with local soft tissue mass disappearance and restoration of the continuity of the lateral periosteum. d. Two months after operation, X-ray showed bone callus in diaphysis, and bony healing in conjunction between host bone and inactivated bone. e. 110 months after operation, X-ray showed fully bony healing and good joint space.