Large tibial bone defects may cause problems at the time of revision total knee replacement. We report on 15 patients (15 knees) followed at a mean of 5.4 years (33-115 months) who underwent revision total knee replacement for severe tibial bone loss using shaped femoral head allograft and Freeman-Samuelson revision components (Zimmer, Winterthur, Switzerland). The mean American Knee Society Score pre-operatively was 22.7 points (0-45) increasing to a mean of 77.2 points (15-95) after operation. The survivorship for the series at 6 years was seven out of nine knees. One patient required an above knee amputation at 3.5 years, whilst another underwent a second revision TKR procedure at 3.4 years. Thirteen knees did not require further surgery and showed a mean time for allograft incorporation of 1.9 years (12-36 months) with no component migration. Severe tibial bone loss at the time of revision TKR surgery is a difficult problem to treat. Our case series demonstrates that when shaped femoral heads are used as structural allograft along with long stemmed components a successful result can be achieved.