Without proper treatment rheumatoid arthritis can lead to pain, instability and destruction of the elbow joint. As with artificial knee replacement various designs are available and in general non-constrained and semi-constrained designs are preferred. Fully constrained designs should be avoided due to high loosening rates. Results have shown a significant pain reduction, however, a restricted range of motion has to be expected. Restrictions in load-bearing and mobility are among the major problems after elbow arthroplasty in patients with rheumatoid arthritis which have to be discussed with the patient before surgery. Future studies will have to evaluate the effectiveness of new modular designs.