The rising prevalence of total joint replacements (TJR) as a treatment for degenerative joint disease has brought implant loosening and failure into sharper focus. This issue is particularly concerning as an increasing number of younger patients undergo both primary and revision TJR surgeries, often requiring further corrective procedures. Despite the growing demand, current clinical practices lack effective tools for the early identification of TJR failure, and there is a significant gap in leveraging molecular effectors for monitoring postoperative complications. This book chapter explores the emerging potential of aggregation-induced emission luminogens (AIEgens) in addressing this unmet need. It begins by examining the underlying mechanisms of TJR loosening and highlighting key molecular effectors implicated in this process. The discussion emphasizes the role of wear particles generated by implants in driving inflammation, osteolysis, hypersensitivity, and genotoxicity, while identifying the molecular effectors central to these responses. The chapter then investigates the application of AIEgens for detecting these molecular effectors, offering insights into their direct and indirect use in identifying clinically significant biomarkers such as TNF-α, osteocalcin, and urinary N-terminal telopeptide. By enabling the early detection of bone loss and implant failure, AIEgens represent a transformative approach to advancing our understanding of skeletal health and improving patient outcomes. The potential of AIE-based technologies to provide timely interventions and enable personalized treatment strategies underscores their promise for optimizing bone health management. Continued research and development are essential to translate these innovations into practical, clinically viable solutions that enhance the management of implant-related complications.