Introduction: Knee (distal femur and proximal tibia) is the most frequent site of primary bone tumors. Earlier the treatment of majority of these tumors were amputation but in the last few years, the concept of limb salvage surgery has gradually developed & advancements in musculoskeletal tumor management has given both surgeons and patients better treatment options and better quality of life.

Methods: It’s a retrospective cohort study conducted at Department of Surgical Oncology, Vydehi Institute of Medical Sciences. Between 2012 and 2021, 122 patients underwent surgery for lower limb malignant tumours around the knee. The Musculoskeletal Tumour Society (MSTS) scoring system was used to assess their functional outcome.

Results: The study comprised 122 participants with a mean (SD) age of 31.71 (10.42) and an age range of 14 to 54 years. The most common location was distal femur and most of it are giant cell tumors. On MSTS score analysis, the majority of cases fall into Grade II (51.64%) and Grade I (46.72%), with only a small fraction in Grade III (1.64%) and no Grade IV cases reported. The mean MSTS score is 22.15. Age, gender, and MSTS grade did not significantly correlate with one another. Our findings demonstrated a strong correlation between MSTS grade and tumor site and histological type.