Over the last twenty years, the increased use of total elbow replacement for repair of rheumatoid arthritis, primary and post-traumatic osteoarthritis, and distal humerus fractures has resulted in a corresponding increase in implants requiring revision. Aseptic loosening, resulting from implant malpositioning, is the most common cause for revision surgery. Implant positioning is affected by both implant design and surgical selection of landmarks. This work was based on the postulate that an increased understanding of joint morphology and the use of a computer-navigated elbow implant system would result in improved implant alignment. This treatise includes morphologic analyses of the humerus and ulna, as they relate to elbow implant design and sizing. Furthermore, sources of error existing in current clinical practices were explored in a study of surgeon dependent landmark identification for the humerus. The issue of ulnar component alignment was addressed by determining the relative positions and orientations of different methods for defining the ulnar articulation axis. Using the information of these studies, a set of computer-navigation tools and algorithms was developed to allow for optimal implant positioning. The computer-navigation tools guided humeral, ulnar, and radial components in an in-vitro series of experiments. Errors in component positioning were still present with the computer-assisted surgery system, however the magnitude of these errors was less than the surgeon errors previously identified. To determine the effects of the surgeon errors on joint loading, and ultimately implant durability, a modular implant, equipped with a load cell was tested in-vitro in an elbow motion simulator. The implant was optimally positioned using the computer-assisted technique, and simulated nine different alignment errors while recording wear-inducing bending loads during elbow flexion. The optimally positioned implant had lower loads than when it was malpositioned, and certain positioning errors resulted in larger load increases than others. In summary, these studies identified sources of error in, techniques for, and consequences of not, achieving optimal implant alignment in total elbow arthroplasty. These findings will assist surgeons and implant manufacturers in the design of implants and surgeries for these reconstructive procedures of the elbow.