Resection of musculoskeletal sarcoma can result in large bone defects where regeneration is needed in a quantity far beyond the normal potential of self-healing. In many cases, these defects exhibit a limited intrinsic regenerative potential due to an adjuvant therapeutic regimen, seroma, or infection. Therefore, reconstruction of these defects is still one of the most demanding procedures in orthopaedic surgery. The constraints of common treatment strategies have triggered a need for new therapeutic concepts to design and engineer unparalleled structural and functioning bone grafts. To satisfy the need for long-term repair and good clinical outcome, a paradigm shift is needed from methods to replace tissues with inert medical devices to more biological approaches that focus on the repair and reconstruction of tissue structure and function. It is within this context that the field of bone tissue engineering can offer solutions to be implemented into surgical therapy concepts after resection of bone and soft tissue sarcoma. In this paper we will discuss the implementation of tissue engineering concepts into the clinical field of orthopaedic oncology. 1. Introduction Bone has to carry major loads. To fulfil this task it is created as a composite material, which comprises primarily of collagen, noncollageneous proteins, and hydroxyapatite. Its complex structure contains a wealth of mechanically relevant details [1]. Bone is a composite in several senses that is, being a porous material, a polymer-ceramic mixture, a lamellar material, and a fibre-matrix material. Its mechanical properties will therefore depend on each of these aspects of composition and structure. In general, bone displays a high intrinsic regenerative capacity following trauma or disease. Therefore, the majority of fractures heal spontaneously by a recapitulation of the pathway of normal fetal skeletogenesis, including endochondral and intramembraneous ossification [4]. Refinements in surgical techniques, implant design and postoperative care have significantly improved treatment outcomes of complex fractures and defects as caused by high-energy trauma, disease, developmental deformity, and revision surgery. However, there are conditions in which bone regeneration is compromised or in which bone regeneration is required in a large quantity. A situation of the latter entity is the resection of malignant bone and soft tissue sarcoma. This can result in large defects where regeneration is needed in a quantity far beyond the normal potential of self-healing [5]. Furthermore, an adjuvant
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