OBJECTIVES: Total Knee Replacement (TKR) is a commonly used intervention in the treatment of advanced stage osteoarthritis. Aseptic loosening, a failure of the prothesis-bone fixation in the absence of infection, is the most common cause of revision. Several studies have investigated risk factors associated with aseptic loosening, though identification of patients at risk remains elusive. There is a need for foundational work which further investigates factors associated with aseptic loosening. METHODS: Data was extracted from IBM Marketscan® Commercial Claims and Encounters 2015-2019. Patients aged 22-64 years who received a primary cemented TKA were eligible for inclusion. Additional exclusions included non-elective procedures, patients with another knee-related procedure within 12 months baseline, osteomyelitis, bone neoplasm, fracture, and deep/organ space infection. General linear models were used to evaluate potential patient and provider factors associated with aseptic loosening. Kaplan-Meier curves were generated to assesses survival associated with covariates. RESULTS: A total of 77,478 patients were eligible for analysis for the general linear models. In the GLM model, younger age, region, discharge status, and prior ACL injury were significantly associated with aseptic loosening. CONCLUSIONS: These findings are supportive of other studies which identify younger age as a risk factor. Additionally, surgeon experience and prior ACL injury may play a role.