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 Santo Borromeus Hospital is equipped with laminar airflow, and the latest and best operating equipment to ensure the best quality for orthopaedic surgery. Santo Borromeus Hospital is equipped with Radiology support services such as 3T MRI and 512 Slice CT Scan as well as a medical gymnasium to assist post-operative patient recovery.

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.

Following the example of Maria Elisabeth Gruyters, the founder of the Congregation of the Sisters of Charity of Saint Charles Borromeo, we are committed to offering this service to all people without discrimination as a form of devotion to God.

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

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.

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 SURGERY TOTAL KNEE REPLACEMENT?

Total knee replacement surgery or often known as Total Knee Replacement (TKR) implant surgery is surgery to replace damaged joint surfaces, usually due to arthritis such as ostearthritis (calcification) that has not responded to drugs, injections and other therapies. As implant technology develops, the implant design improves so that it can make your knee feel closer to normal again. This TKR surgery will help:

• reduces pain in the knee
• reduced rigidity
• improve your ability to move.

The knee joint is a hinge joint formed by the thigh bone (femur) and the shin bone (tibia). A normal knee joint is lined with smooth joint cartilage. As arthritis occurs, this lining is lost. The joint surfaces become rough, which causes pain and stiffness. The damaged cartilage cannot regenerate properly despite injections of oil/joint lubricant/other regenerative therapies. This TKR surgery resurfaces the damaged or missing cartilage area with metal and plastic components.

RISKS AND COMPLICATIONS OF TKR SURGERY

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 (

If you experience redness, pain or swelling of the limbs, or shortness of breath, you should come to 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.

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.

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.

When you arrive at 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

OPERATION PREPARATION

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.

Total waktu di ruang operasi kira-kira lima jam.

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 urine catheter will be removed in the afternoon after you are able to move both limbs.

In the afternoon you will be trained by the physiotherapy team to sit, stand and walk within tolerance.

The nerve block will be removed 24-48 hours after surgery.

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.

• 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.

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)