A prosthetic elbow replacement includes a humeral component having a stem dimensioned to fit within a medullary canal of the humerus and having a yoke connected to the stem wherein the yoke terminates in spaced apart arms. A pivot pin is mounted between the arms for rotational movement with respect to the humeral component. The pivot pin has a transverse throughhole. There is an ulnar component having an ulnar stem including a distal end dimensioned to fit within a medullary canal of the ulna and an opposite proximal end dimensioned to fit within a first end opening of the throughhole. The ulnar component has a mounting cap dimensioned to fit within a second end opening of the throughhole. A fastener connects the ulnar stem and the mounting cap such the proximal end of the ulnar stem is positioned within the first end opening of the throughhole and the mounting cap is positioned within the second end opening of the throughhole. The pivot pin rotates to allow for flexion of the prosthetic elbow replacement, and also allows for axial rotation of the ulna component in the humeral component.