Gandhi MJ, Eyre-Brook AI, Gopinath P, et al. - This study was sought to perform a retrospective review to identify total elbow arthroplasties (TEA) revisions performed between November 2008 and July 2018 in the tertiary center. They evaluated radiological implant loosening by 5 orthopedic surgeons. They estimated inter-observer agreement (kappa coefficient). They compared majority’s view of radiological loosening with intra-operative findings. They distinguished 93 sets of radiographs with implant stability clearly documented in their operation note. The data demonstrate that the definition of loosening provides a reproducible inter-observer and intra-observer agreement of radiographic component loosening. The outcomes suggested that the radiological findings may not translate to intra-operative findings and we would advise surgical strategies for TEA revision should include the possibility of needing to conduct a dual implant exchange.