This first guide devoted to this burgeoning topic, this authoritative reference presents the current understanding of the phenomenon of aseptic loosening of total joint replacements from the molecular and cellular mechanisms of periprosthetic bone loss to the clinical presentation and management strategies-reviewing the properties of ceramic, metal, and polymer materials used in the replacement of joints, as well as current research on bone remodeling, wear resistance, the long-term care of implants, and emerging developments in gene therapy and tissue engineering.