A 15-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 high and low mixed signal in distal femur. The lowest boarding of tumor lies 2cm over Insall line which was classified as Type I. 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 weeks after operation, X-ray showed reposition of inactivated bone with outside cortical allograft bone bridging. e. Nine months after operation, X-ray showed diaphysis fracture and bony healing in conjunction between host bone and inactivated bone. f. 30 months after reoperation, X-ray showed fully bony healing and good joint space.