Aseptic loosening refers to the separation of the prosthesis from the bone, which leads to instability of the prosthesis. Loosening may occur at the interfaces between cement and bone, or between prosthesis and cement. The loosening caused due to the long-term use of prosthesis is inevitable; however, early loosening depends on specific causes including patient related factors, implant design and technical errors in surgery. Abrasion is a very common and serious complication that accounts for approximately 25% of all revision total knee arthroplasties. In case of abrasion, a vicious cycle of osteolysis occurs and wear accelerates loosening. Wear is commonly classified as abrasive/adhesive wear, fatigue wear, scratching and corrosive wear. Osteolysis is usually caused by inflammatory reactions caused by wearing particles of polyethylene or in the presence of infection. Developments in the production of polyethylene material reduced the incidence of wear and resulting osteolysis. Histologically, there are hyper-cellular membrane formations including histiocytes and giant cells activated by wear particles.