Artificial joint replacement can be said to be one of the greatest breakthroughs in orthopedic surgery in this century. At present, it has been applied to the treatment of shoulder, elbow, wrist, interphalangeal joint, hip, knee and ankle joints, etc. Total artificial hip and knee replacement is the most common, and the surgical requirements for total artificial elbow replacement are so high and difficult that only a few hospitals in the country are carrying out this surgery. The first generation elbow joint is a hinged ulnar joint prosthesis, the humerus is made of polyethylene, and the radial tuberosity has to be resected but not replaced. The polyethylene material had a high loosening rate due to lack of stability, which led to the development of the second generation elbow joint, which had a metal humerus and an improved locking mechanism for the rotating shaft, a design that reduced the loosening rate by 50%. The third generation elbow joint prosthesis requires simultaneous replacement of the radial tuberosity, the winged design with ulnar eminence-like support and the emergence of the humeral lengthening stem have further reduced the mechanical loosening rate. The further stage of development is characterized by the design of the humerus externally rotated angle and three different sizes of models, whereby humeral-radial replacement is not mandatory in order to meet the different anatomical requirements. Indications for surgery 1, severe limitation of elbow joint function 2, severe pain in the elbow joint 3, severe instability of the elbow joint 4, part or all of the elbow joint stiffness 5, elbow joint bone tumors Traumatic arthritis, elbow joint instability and fracture non-healing, deformity healing or ankylosis left behind after trauma of the elbow joint is one of the main causes of elbow disability, which seriously affects the patient’s life and work. For such complex elbow problems, it is clinically quite tricky to reconstruct the anatomy and function of the elbow joint because of the presence of ankylosis of the bones, periarticular fibrosis and scarring. The indications for total elbow arthroplasty (TEA) have gradually expanded with advances in the design of artificial total elbow joints and joint replacement techniques; initially, TEA was used mainly for rheumatoid arthritis of the elbow. Recently, many papers have reported the successful application of TEA in other elbow disorders, such as traumatic arthritis of the elbow joint, osteoarthritis, distal humerus fracture with malunion or bone nonunion, and comminuted distal humerus fracture in the elderly. Therefore, TEA, as a salvage surgical method, provides a viable treatment for such complex elbow disorders. Outcome The average range of motion of the osteoarthritic joint, flexion and internal and external rotation increased by 20 degrees after surgery, which should improve the mobility of the joint considering the previous presence of stiffness for many years, thus the replacement surgery was successful with a 95% rate of major or total pain relief. Typical case Male, 27 years old, was admitted to the hospital with multiple traumatic injuries to the right elbow and the whole body, and was diagnosed as comminuted, open fracture with dislocation of the right elbow joint and multiple fractures of the whole body. Among them, the patient’s right elbow was a disfiguring injury, with obvious pain in both flexion and extension, which seriously affected the patient’s elbow joint activities. After the vital signs were stabilized, the right elbow arthroplasty was performed, and after half a month of postoperative functional exercise, the mobility of the right elbow was able to reach 75º of active flexion and 10º of straightening, 100º of passive flexion and 5º of straightening, and the forearm rotation was basically normal. Postoperative elbow flexion and extension mobility is good Artificial total elbow joint replacement can be a good solution for patients with elbow dysfunction, significantly improve the quality of life, reduce the incidence of disability, and have good social benefits. Artificial total elbow joint replacement has high technical requirements and great difficulty, and there are very few cases every year in China. The Department of Orthopaedic Surgery of our hospital has mastered this technology, which has brought good news to the majority of patients.