Forty-five total elbow replacements using the Mark III GSB prosthesis are reviewed. Average follow-up was 2.7 years. The overall results were good in 87% of cases, fair in 9%, and poor in 4%. Excluding the two poor results, which required prosthesis removal, 96% of cases had no significant pain. The flexion/extension are improved 24 degrees and the supination/pronation arc improved 22 degrees. No prosthesis was loose and only one had a significant radiolucent line. The overall complication rate was 25%. Disassembling of the two components, due to inadequate ligament tension, was the most frequent complication and this occurred in four elbows.