Aims: The aim of this study was to clinically and radiologically assess the outcome of the HINTEGRA total ankle prosthesis. The HINTEGRA implant is an uncemented (hydroxyapatite-coated) prosthesis of anatomical, multiaxial, congruent and unconstrained design. Methods: All of the consecutive 19 patients who got a HINTEGRA total ankle replacement between June 2000 and June 2001 were assessed. Pre- and postoperative functional and clinical assessment was carried out using a questionnaire, range of motion and Kofoed score which assigns 50 points for pain, 30 for function and 20 for range of motion, giving a maximum of 100. Results: 19 patients (6 female, 13 male), mean age 55,3 years (21–82 years), mean followup 14,3 months (10–21 months). The general satisfaction at subjective evaluation was 27,3/100 preoperatively and 80/100 postoperatively. The mean Kofoed score was 26,3 preoperatively and 78,4 postoperatively. The mean range of motion from maximum extension to maximum ßexion was 16,4¡ preoperatively and 29,1¡ postoperatively. None of the replacements showed any progressive radiolucency, although in 3 patients there was a small area (< 2mm) of radiolucency between the tibial component and bone. Conclusions: Our results with the uncemented HINTEGRA, anatomical shaped threecomponent total ankle replacement, are satisfactory and encouraging. Total ankle replacement is a useful alternative to ankle arthrodesis with pain relief and preservation of joint motion and stability.