Authors describe briefly the history of the development of elbow arthroplasty. They report on their experiences with the silicone, cementless, unconstrained elbow prosthesis developed by them and implanted in 23 cases during 3 years. The prosthesis is described, the operative indication and the problems of the operative technique are reviewed. On the basis of their results and the low number of complications this method of operation is suggested first of all for the successful treatment of elbows with rheumatoid arthritis.