Santo Borromeus Hospital was founded on September 18, 1921 by the congregation of the Sisters of Charity of Saint Charles Borromeus from Masstricht, Netherlands as a mission to provide the best quality health services for the people in the Bandung area at that time. The tradition of good health services has been maintained and improved until now. Our Hospital has 5 interconnected main buildings, 10 operating rooms with specialized operating rooms. ultra clean yang dilengkapi aliran udara laminar, dan peralatanperalatan operasi berteknologi tinggi terbaru untuk memastikan mutu terbaik bagi tindakan bedah orthopaedi. Rumah Sakit Santo Borromeus dilengkapi layanan penunjang Radiologi seperti MRI 3T dan CT Scan 512 Slice serta gimnasium medis untuk membantu pemulihan pasien pasca operasi.

OUR VISION MISSION

In the spirit of love, St. Borromeus Hospital offers services to the sick and needy, providing a holistic approach to healthcare in response to the changing needs of society and promoting high standards in healthcare.

Our vision is to be a world-class, trusted and professional service hospital based on the spirit of love.

Our mission is to develop services that
focused on improving quality and patient safety.

We understand that facing surgery can be a stressful experience. In keeping with our Vision and Mission to offer compassionate and high-quality services, this information aims to ease your worries.

Here we will explain the frequently asked questions
and general day-to-day events that may occur during your treatment process. Our pastoral care team is ready to provide spiritual support to all admitted patients. Our dedicated and experienced operating room team (especially the orthopaedic team) is ready to serve you with information and the latest standard of care.

WHAT IS MEANT BY ROBOTIC KNEE REPACEMENT SURGERY ?

Robotic Knee Replacement Surgery is a knee joint replacement surgery affected by arthritis with the help of a robotic arm to assist the orthopedic surgeon during the surgery.

is an arthritis-affected knee joint replacement surgery with the help of a robotic arm to assist the orthopedic surgeon during the surgery. real-time during surgery, allowing the surgeon to make precise and accurate incisions.

This advanced technology can help improve the accuracy of implant placement and restore the anatomical shape of the knee joint to its pre-severe arthritis condition, providing better results and faster recovery time. The new knee replacement is expected to last for decades (90% still functional after 20 years).

WHAT ROBOT WILL BE USED IN THIS OPERATION?

There are several different robots that can assist in the joint replacement surgery process. Each robot is unique as it is programmed to place a specific implant into the knee joint. The robot we use is ROSA®. This high-tech robot will help the orthopaedic surgeon place the PERSONA® implant, a high-tech implant from Zimmer Biomet (USA), which can be PERSONALIZED to your knee anatomy.

WHAT IS THE ROSA® KNEE SYSTEM?

ROSA® stands for Robotic Surgical Assistant. ROSA® Knee System is a robotic surgical assistant developed by Zimmer Biomet for total or partial knee replacement and is available at Borromeus Bone and Joint Centre at RS Santo Borromeus, the first hospital in Indonesia to have this technology. This technology allows the surgeon to create a procedure plan using a 3D model of the patient's knee, resulting in a more precise view and a more personalized approach for each patient. The ROSA® robotic system uses information real-time to assist the surgeon in accurately placing the knee implant based on the unique anatomy of your knee.

RS Santo Borromeus' team of orthopaedic surgeons are equipped with the most advanced technology, treatments, and surgical techniques for knee joint replacements and are located in Bandung, Indonesia, so you don't have to travel far abroad to get the best services and treatments in the field of knee joint replacements.

WHO IS THE RIGHT CANDIDATE FOR KNEE SURGERY

ROBOTICS?

Robotic total knee replacement is suitable for advanced knee joint arthritis patients who:

• Persistent pain interferes with quality of life as it is difficult to move and exercise.

• He has tried all non-surgical treatment options such as physiotherapy, joint lubricant injections, Platelet Rich Plasma (PRP) and stem cell administration.

Notes : for advanced calcification, generally lubricating injections, regenerative therapy will not give satisfactory results.

• Unable to perform daily tasks due to knee joint pain.

OPERATION ADVANTAGES ROBOTIC KNEE REPLACEMENT

The decision to go for knee joint replacement surgery is a joint decision between you, your orthopaedic surgeon, your family, and other medical professionals. Robotic knee replacement offers several advantages over traditional knee replacement procedures, including:

• Improved accuracy and precision: The robotic arm allows for greater precision and accuracy in implant placement, allowing implants to be positioned according to pre-arthritis conditions.

• Faster recovery time: since robotic total knee replacement is less invasive and more precise, it can result in a faster recovery than traditional knee replacement procedures.

• Reduced risk of complications: the robotic arm provides feedback in a real-time to the surgeon, which can help reduce complications during and after the procedure.

• Patient anatomy-driven approach: the robot is programmed to map each patient's unique anatomy, allowing for a customized approach to knee replacement surgery especially with high-tech implants.

HOW ROSA® WORK TO ASSIST THE OPERATION?

During surgery the ROSA® robot uses cameras and optical trackers to locate the anatomy of your knee. This system resembles the highly detailed global positioning system (GPS) you might use in your car. If your leg moves even a millimeter, the robot can tell and adjust accordingly. This helps to ensure that your surgeon's prescribed plan will go smoothly. Throughout your surgery, ROSA® will provide your surgeon with data about your Knee. This information, combined with the surgeon's skill, helps them figure out and position your implant based on your unique anatomy.

WHAT ARE THE RISKS AND COMPLICATIONS OF REPLACEMENT SURGERY SENDI LUTUT?

Infection

Despite all precautions, including the use of antibiotics during surgery, infection can still occur in about 1% of knee replacement surgery patients. The infection may require further surgery and hospitalization. Pre-operative dental check-up is one way to prevent infection after knee replacement surgery. Surgery performed in an ultra-clean operating room will lower the risk of infection.

Blood clotting

The risk of blood clots occurring in the deep veins in the legs is about 20%. The risk of the blood clot traveling to the lungs (pulmonary embolism) is about 1% and can be fatal. Other risks include heart attack or other common medical problems. This risk can be reduced through early mobilization, use of special stockings and blood thinning medication. If you experience redness, pain or swelling of the limbs, or shortness of breath, you should attend the Emergency Department immediately. These may be signs of Deep Vein Thrombosis (DVT/Deep Vein Thrombosis) atau Emboli Paru (PE/Pulmonary Emboli).

Risks due to anesthesia

Problems can occur, but serious problems are very rare. Most knee replacement surgeries are performed under spinal and/or epidural anesthesia. If you have had problems with anesthesia before, please tell your surgeon, anesthesiologist or nurse.

New knee prosthesis that is worn and/or loose.

Your new knee will wear and/or loosen slowly. Joint replacement or revision may be required after 15-20 years. Damage to the artificial knee joint is possible, but rare. If this happens, a second surgery is required.

Anemia due to blood loss during surgery

Blood transfusions may be required during or after surgery

Other complications

Some other complications that may occur include nerve injury, vascular injury, superficial infection, hematoma, numbness around the knee, joint stiffness, persistent pain and others. During surgery, fractures may occur that require additional implants.

THINGS TO DO BEFORE COMING TO THE HOSPITAL

It is important that you bring your x-rays and any medications you are currently taking. If you are taking blood thinners or arthritis medications, please follow the instructions given by your specialist, as sometimes these medications need to be stopped in preparation for surgery. Smoking also increases the chances of anesthesia-related complications which can sometimes be serious. While it is best to quit smoking permanently, stopping smoking at least six weeks before anesthesia will reduce many of these complications. When coming to the hospital, you can head to the Inpatient Registration (RRI) section in the Elizabeth lobby of Santo Borromeus Hospital.

What to bring to the hospital?

- Your insurance card/identification card

- Your insurance card/identification card

- X-rays, CT scans, or any relevant laboratory results

- Glasses, contact lenses and hearing aids if required

- Loose and comfortable everyday clothing (e.g. tracksuit, elastic pants)

- Supportive shoes, these shoes should be flat with rubber soles. Make sure the shoes are not tight as your feet may swell slightly after surgery. Do not bring flip-flops. Sandals are fine as long as the heel is covered.

– Walker / walker if you already have one, if not we will

WHAT ARE THE PREPARATIONS BEFORE SURGERY?

• You will be issued with an identification bracelet upon arrival at the hospital. This bracelet must remain on throughout your stay at our hospital for identification and safety.

• Any blood tests, x-rays or other procedures that have been ordered by your doctor and have not been completed will be completed as soon as you arrive at the treatment room.
• Perawat Anda akan melakukan serangkaian observasi dasar (misalnya, suhu, denyut nadi, tekanan darah).

• A dietician will visit you before your surgery to assess your nutritional status, which is important to speed up the post-surgery recovery process.

• The nurse will tell you when to stop eating and drinking in preparation for surgery. Two hours before surgery you will be given an Apple cider drink to energize you for surgery and recovery.

• You will be asked to shower before the surgery and the nurse will prepare the surgery site according to the doctor's requirements.

• You will be measured for special stockings and will have to wear them on the healthy limb before going to the operating room.

• Do not wear any jewelry to the operating room.
• The surgery takes about two hours but you will remain in the recovery room until the anesthesiologist deems you stable enough to return to the room.

• The total time in the operating room is approximately five hours. provide for you.

PASCA OPERATION

• You will stay in the recovery room in the operating room after the surgery. When you are ready to return to your room, you will be transferred to a bed.

• The limb area will be fitted with compression stockings and there may be a drain to remove excess fluid from the surgical site.

• Your nurse will often observe your vital signs (temperature, pulse, blood pressure), color, warmth, sensation, and leg pulse a few hours after surgery.

• Immediately after your surgery, you will be on bed rest.
• You can eat normally within your tolerance immediately.
• The infusion is maintained for 24 hours to maintain your fluid intake and access to antibiotics.

• The urinary catheters will be removed in the afternoon once both limbs can be moved.- 6-8 hours post-operatively you will be trained by the physiotherapy team to sit, stand and walk as tolerated.

• The nerve block will be removed 24-48 hours after surgery.
• The next postoperative day if you are feeling strong you can continue your home care.

PAIN RELIEF

Although we try to relieve your pain as much as possible, sometimes your pain may not go away completely, but your pain must be well controlled so that you can move, do physiotherapy exercises and sleep. If your pain relief is not adequately controlled, please let the nurse know. Also tell the nurse if you feel itchy, nauseous or want to vomit. These may be side effects of the pain medication and are usually easily managed. Your pain will be managed with nerve blocks and pain tablets.

DISCHARGE PLANNING

Knee replacement surgery can take up to three months to make a full recovery. It is expected that you will achieve the following before discharge:- Pain that can be controlled with pain tablets.

- You will mobilize safely and independently with a walking aid/transfer safely.

You can generally go home on the second postoperative day.

WHY CHOOSE SANTO BORROMEUS HOSPITAL FOR KNEE JOINT REPLACEMENT SURGERY?

1. St. Borromeus Hospital has an operating room ultra clean dengan aliran udara laminar yang steril sehingga ideal untuk operasi penggantian sendi.

2. The implants used are well-known implants that have a proven reputation for durability.
3.  Completeness of surgical support tools in accordance with the best standards.

4. Surgical care by competent hip and knee subspecialists.
5. Holistic care is integrated with various other specialists and subspecialists.

6. Skilled nursing staff and experienced physiotherapists are supported by complete and modern medical rehabilitation equipment facilities.

7. Fast recovery process with minimal pain due to adapting the rapid post-surgery recovery program.

8. Complete, modern and integrated diagnostic and therapeutic support facilities

YOU SHOULD KNOW

• Not all knee arthritis requires surgery.
• Not all knee arthritis, especially advanced stages with severe joint cartilage damage respond to medications, physiotherapy and various advertised injections or supplements, so knee joint replacement surgery is required to address this situation.

• Do not delay surgery when it is time because long-term consumption of pain medications has side effects that are more dangerous than the side effects of surgery.

For further information and consultation appointment with Orthopaedic Doctor Sub Specialist in Pelvis and Knee, you can contact :

Sr. Susi Susilawati (WA : 081220220773)

Sr. Siska Oktaviani (WA : 085216851922)