Osteosarcoma is the most common bone sarcoma in children and adolescents. It occurs mainly around the knee joint; the distal femur is the most common location. When it occurs in children who are skeletally immature, a significant limb length discrepancy can occur. The Repiphysis prosthesis was developed in the 1980s to assist in reconstruction of the affected limb in these patients. Ten articles were reviewed to identify the challenges and complications that affect the functional outcome on this population. The reports included patients, aged 7–16 years, who were skeletally immature and had bone sarcomas of the lower extremities. Complications reported by the authors were similar and included aseptic loosening, mechanical failure, infection, flexion contracture of the knee, fracture, and neuropraxia.