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We present the functional and radiological results after implantation of thirty five uncemented Buechel Pappas total ankle replacements by an independent surgeon. All consecutive uncemented Buechel Pappas total ankle replacements were performed by the senior author (MSA) between 1990 and 2005. All ankle replacements were performed for osteoarthritis. The patients were assessed clinically and radiologically. The average follow-up period is five years.Nine female patients and 25 male patients with an average age of 69(58–84) were enrolled. One patient died before follow-up. Ninety seven percent of patients were happy with their operation and ninety seven percent thought it was successful. Sixty six percent of patients had no, or occasional pain. All patients were mobile and forty five percent of patients required no walking aids. Only three percent of patients required two walking aids. The American Orthopaedic Foot and Ankle Society Score was 73.3(54–100) at follow-up, compared to 34.6(20–56) pre-operatively (p<0.001). One prosthesis was revised. Two fractured medial malleoli occurred and no deep infections were noted.Buechel Pappas Uncemented Total Ankle replacement, performed by an independent surgeon, can give intermediate results comparable to data published by the designer. Patient selection is paramount. Our data compares well with results from other uncemented total ankle replacements.