Abstract: Objective To compare the effectiveness of whether or not using structural allograft in treatment of patients with serious bone defects in revision total knee arthroplasty （RTKA）. Methods Thirty-four patients who underwent RTKA in our department from July 2010 to June 2013 were selected with an average age of 64.6 years （range 51-76） and follow-up period of 28.5 month（range 14-46）. They were divided into treatment group and control group according to the usage of allograft or not. Patients in treatment group underwent structural allograft during the operation. In control group， morselized bone graft and bone cement were used to repair bone defects. Knee Society Score were used to evaluate the improvement of symptoms and joint function. And X-ray films were used to evaluate prosthesis location and bone graft healing. Results Two cases were lost following up in two groups， one in each group. In the treatment group， all the allograft were healed. Prostheses were in normal location in all patients. The mean KSS score during the follow up was higher than the preoperative score in both groups （treatment group t=8.839， P＜ 0.05； control group t=11.824， P＜ 0.05）. Before operation， the KSS clinic score in treatment group was lower than that in control group ［（38.19±18.71）vs （52.39±9.79）， t=2.891， P=0.008］. But the KSS clinic score ［（85.19±10.23）vs （90.39±5.71）， t=1.859， P=0.072］， pain score［（45.00±5.16）vs （43.33±5.69）， t=0.859， P=0.377］ and function score ［（63.13±19.12）vs （72.78±16.74）， t=1.557， P=0.130］ during the follow up were of no significant difference between two groups. Conclusion Structural allograft in treatment of patients with serious bone defects in RTKA shows good efficacy. There is no significantly clinical difference compared with other methods.