We performed a prospective study to evaluate the application of impacted allograft bone particles at revision surgery of severely defective femora. According to the Endo-Klinik classification, 21 hips had grade III or IV femoral defects, of which 4 had a preoperative fracture. No femoral re-revisions had been necessary after a mean follow-up of 60 (41-85) months. The mean Harris Hip Score improved by 39 points to 78 points. 2 fractures occurred postoperatively, 1 of which needed reoperation with osteosynthesis. 1 patient needed a closed reduction after dislocation. 4 stems showed significant subsidence (> 10 mm) in the follow-up radiographs. In total hip revision surgery, even severely damaged femora can be successfully treated by impaction allografting.