Abstract Objective To explore the clinical effect of curettage and cement filling or knee joint replacement in the treatment of giant cell tumor of bone around the knee joint. Methods From February 2010 to March 2018, the clinical data of 30 patients with GCT around the knee joint were analyzed retrospectively. 17 patients were treated with curettage and bone cement filling (knee conserving group) and 13 patients were treated with segmental resection and total knee replacement (joint replacement group). The postoperative complications, MSTS ,HSS were compared.Results ①There was significant difference in operation time, intraoperative hemorrhage and hospitalization cost between the two groups (P < 0.001). There was no significant difference in perioperative complications (P > 0.05).There was no significant difference in perioperative complications (P > 0.05).②There was no significant difference in the recurrence rate between the two groups (P > 0.05).③The MSTS and HSS scores of the knee conserving group were significantly higher than that of the joint replacement group (P < 0.001).④The recurrence rate of patients with Campanacci grade III was significantly higher than that of patients with Campanacci grade II, and the recurrence rate of patients with tumor volume ≥ 200ml was significantly higher than that of patients with tumor volume < 200ml (P < 0.05).Conclusion The function of knee joint after tumor curettage and cement filling is better than that of total knee replacement. The pathological grade and volume of tumor are the main factors affecting its recurrence.