Background: With the development of medical technology, credible options for defect reconstructions after the resection of benign bone tumors of the lower extremities has become a high priority. As the current reconstructive methods commonly used in clinical practice have some flaws, new methods of reconstruction need to be explored. We aimed to prepare a new kind of bioactive scaffold for the repair of bone defects through a stem cell rapid screening–enrichment–composite technology system

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... oped by our team. Furthermore, we aimed to investigate the curative effects of these bioactive scaffolds. Methods: Firstly, cell count, trypan blue exclusion rate and ALP staining were used to evaluate changes in enrichment efficiency, cell activity and osteogenic ability before and after enrichment. Then, the scaffolds were placed under the skin of nude mice to verify their osteogenic effects in vivo. Finally, the scaffolds were used for the reconstruction of bone defects after operations for benign bone tumors in a patient's lower limb. The healing status of the defect site at 1 and 3 months was assessed by X-ray and the Musculoskeletal Tumor Society (MSTS) score was applied to reflect the recovery of patient limb function. Results: The system effectively enriched stem cells without affecting the activity and osteogenic abilities of the bone marrow mesenchymal stem cells (BMSCs). Meanwhile, the bioactive scaffolds obtained better osteogenic effects. In patients, the active scaffolds showed better bone integration and healing status, and the patients also obtained higher MSTS scores at 1 and 3 months after surgery. Conclusion: As a new technique, the rapid screening–enrichment–composite technology of stem cells demonstrates a better therapeutic effect in the reconstruction of bone defects after surgery for benign bone tumors of the lower extremities, which will further improve patient prognosis.