revision and primary complex total knee arthroplasty using fully constrained implants: a retrospective series

Revision total knee arthroplasty (tka) is a complex procedure often required in cases of implant failure due to infection, loosening, or instability. full-constrained implant prostheses, offer enhanced joint stability while preserving the knee's biomechanical function. however, data on the usage and outcomes in the indonesian population are limited. this is a retrospective case series to describe the clinical characteristics, surgical indications, and early postoperative outcomes of patients undergoing revision/ complex primary tka with full-constrained implants between january 2019 and january 2025 at prof. dr. r. soeharso orthopedic hospital surakarta, indonesia. a total of 18 patients underwent full-constrained tka; 10 were female and 8 were male patients, with a mean age of 61.2 years (43 – 72) and mean body mass index (bmi) 26.05 (21.51 – 34.55). twelve patients had tka on the right knee, while 6 patients had tka on the left knee. the primary indications for revision were periprosthetic joint infection in 12 patients, aseptic loosening in 3 patients, instability/dislocation in 2 patients, and sequelae of septic arthritis in 1 patient. the mean length of hospital stay was 5.3 days (3 – 7 days) and mean follow-up duration was 2.61 years (1 – 7). two patients developed complications involving septic arthritis and recurrent infection. fully constrained implants in tka offer a reliable solution for patients with compromised ligamentous structures and severe bone loss, particularly post-infection. good clinical outcomes can be expected but careful patient selection and potential complications should be anticipated.