Radial Extracorporeal Shock Wave Therapy (rESWT) is applied as a conservative treatment modality in orthopedics, yet its effectiveness in addressing aseptic loosening of cementless joint prostheses remains unclear. Through animal experimentation, we have revealed that in a titanium particle-induced osteolysis rat model, rESWT intervention significantly increased periprosthetic bone density compared to untreated controls, concurrently reducing osteolytic lesion area and lowering serum IL-1β levels. Histological analyses demonstrated a relative decrease in osteoclast counts within the treatment group versus non-treated controls. These findings indicate that rESWT, through mechanisms involving anti-inflammatory actions and suppression of osteoclastogenesis, may serve as a non-invasive therapeutic strategy for preventing and managing periprosthetic bone loss, demonstrating clinical potential to delay or eliminate the necessity for revision surgeries.