Sir,We read with interest the article by Kumar and Mahanta1 titled as “Primary total elbow arthoplasty” and would like to discuss the few issues regarding this manuscript.The authors have not mentioned whether they have locked the humeral and ulnar components before inserting them into the respective bones and if not, which component was fixed first (authors preference in 11 cases).The authors have not mentioned how to put the hinge screw (medially) and then look for the slot for locking screw which is to be fixed from anterior side. Since the working space from anterior side is little after engaging the two components. With linked implants, disassembly of the components or breakage of the axle locking mechanism or disassociation of the components occur which represents failure.23Regarding implant size the author says “The vertical height of the prosthetic hinge was compared with the gap between the cut ends of the humerus and ulna in both, extension and flexion. It may be necessary, to resect more bone from the distal humerus to accommodate the hinge, in patients with marked contractures of the flexors and extensors”. The authors have not mentioned whether they used different stem sizes (humeral or ulnar) in different patients and whether they compared length with the normal side (preoperatively or intraoperatively) which might have been the reason for limb length discrepancy in (36%) of patients in the present study.