With the development of newer orthopedic technology, the surgeon is blessed with a wide selection of methods to bridge the defects created by the local resection of primary malignant bone tumors. We can elect to perform either allograft operation, resection arthrodesis, or a customized total joint replacement. Each of these methods has advantages and disadvantages. The surgeon must use sound judgment in selecting the best approach on the basis of experience and knowledge of the biologic behavior of the particular tumor for the individual patient. Sometimes combinations of these techniques are helpful. If one method fails, such as in the case of a total joint replacement, one can always perform an arthrodesis as a back-up procedure.