Total knee arthroplasty (TKA) is an effective surgical procedure commonly performed to treat degenerative knee diseases. The procedure can lead to complications that necessitate revision surgeries, with aseptic loosening standing out as one of the predominant causes of surgical failure. The case is presented of a 56-year-old female patient who underwent TKA due to the primary gonarthrosis in her right knee. The patient experienced aseptic loosening and a periprosthetic fracture associated with osteolysis. The potential factors that may have contributed to the failure of the initial surgery are described. The surgical technique and the quality of the cement mantle are factors that significantly influence the success of the procedure. This study aims to describe how the cementation technique may impact the onset of aseptic loosening. Any irregularities in the formation of the cement mantle should be taken into account, as they may lead to complications such as aseptic loosening.