AIM: Osseous defects of the human skeleton are a common problem in reconstructive orthopaedic and trauma surgery. In spite of a long-standing history of research on different organic and inorganic bone replacement materials, a clinically applicable alternative to autogenous bone transplants has not been found. METHODS: The current paper describes a novel bone replacement material, which is vitalised through injection of autologous bone marrow. Industrially processed bone allografts were used for bone replacement; the cancellous bone graft was gained from femoral heads from living human donors and processed by a French tissue bank (Banque de Tissus France, TBF). Sterile packed allogenic bone grafts can be stored at room temperature, are easy to handle and can be adapted to almost every bone defect due to their stability and versatility. RESULTS: From July 2003 to February 2006 125 patients,70 men and 55 women, underwent bone grafting with composite transplants composed of autogenous marrow cells and industrial processed bone allografts. The average age at surgery was 62 (14-84) years; the follow-up period was 11 months. The indication to use the allograft included the whole spectrum of bony defects conventionally treated with autologous cancellous bone grafts such as primary and revision surgery in THA (n = 64) and the treatment of pseudarthrosis particularly of the lower limb (n = 30). CONCLUSION: In comparison to current bone replacement materials applied in clinical use, this approach promises to replicate the biomechanical and biological properties of autogenous cancellous bone. This is an important advantage over conventional approaches to ensure successful healing and regeneration of bone defects. Hence application of vitalised bone allograft represents an important alternative to conventional autogenous cancellous bone which avoids certain complications associated with harvesting and transplantation of autogenous bone. This applies in particular in situations in which harvesting of autogenous cancellous bone is not or no longer possible.