Objective To propose some detailed methods for diagnosis of aseptic loosening failure in clinic by studying the mechanical mechanism and the specific causes of aseptic loosening failure after the total hip arthroplasty (THA). Methods The causes of aseptic loosening were investigated from the view of biomechanics, such as strength of the bone cement layer, interface fretting, stress shielding, wear and osteolysis; the relationships between aseptic loosening failure and products, clinical and patient factors were analyzed; the method to detect loosening before the revision surgery was also studied. Results The reasoning route for aseptic loosening failure analysis after THA was proposed, and detection of aseptic loosening with fluoroscopic analysis (FSA) technique before the revision surgery was conducted successfully. Conclusions The reasoning route for aseptic loosening failure analysis can help to discover reasons of failure occurrence. Loosening can be detected and confirmed in vivo by FSA method, which can also assist the clinician for diagnosis and treatment of aseptic loosening after the THA.