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Background: Total hip arthroplasty is one of the most successful operations medicine can offer. As more patients undergo total hip arthroplasty the revision burden increases proportionately. This is a cohort study of the Arcos Modular Femoral Revision System. Methods: The primary outcome was rerevision of the femoral component. Secondary outcomes include complications and radiological and clinical outcomes over 5 years. Results: A total of 74 patients were recruited, and the femoral survival rate was 100% at 5 years with 12 censorships. A total of 31 patients were given Proprosky 3/4 preoperatively. Eleven patients underwent further procedures; however, no femoral components were revised. Kaplan-Meier analysis was performed by a biostatistician. Patients demonstrated a consistent and sustained improvement in Harris hip score, Oxford hip score, and EQ-5D. Radiological review revealed minimal and stable lysis around the femoral components. Conculsion: The ARCOS Modular Femoral Revision System was designed to offer a range of options to allow femoral bone stock preservation and avoiding conversion to an endoprosthetic and seems to be effective in the medium term.