Radial head replacement should be a routine treatment in cases of non-reconstructable radial head fractures. With the growing number of radial head arthroplasties, we are going to see more complications related to this procedure. We describe a case of aseptic destruction of the elbow joint, probably related to the release of polyethylene particles from the prosthetic head. Removal of the implant and extensive synovectomy was performed, leading to an excellent clinical outcome with reduction of pain and increase in the range of motion. The clinical improvement was not accompanied by radiographic change.