We assessed the long-term results in 22 patients with rotationplasty after resection of high-grade malignant bone tumors. We used established methods (QLQ-C 30; FLZ) to evaluate the quality of life, diplomas, life-contentment, occupational situation and marriage status. After 10-year follow-up, we found no reduction in psychosocial adaptation, and life contentment was about the same as in healthy persons. We therefore recommend rotationplasty instead of amputation whenever conventional limb salvage is impossible.