Dr Henrik Malchau’s MGH Service 2009
Clinical Secretary:
Research Secretary:
Direct line to office:
Mobile phone:
Mrs Linda Comeau 617 643 1322
Ms Betty Gilman 617 726 3866
47548
617 331 1055
Schedule:
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Monday – Research
Tuesday – OR in afternoon following Dr Rubash’s AM OR; occasional full OR
day
Wednesday- Morning clinic of 10-15 patients; usually done by noon or 12.30pm;
dictations to follow clinic
Thursday – Research usually; one full OR day monthly; assisting in Dr Bedair’s
OR monthly
Friday – Research
Care and rounding of Drs McCarthy/Bedair patients as needed.
OR cases
Templating: Please see appendix for MDesk instructions; the fellow is expected to
template, select the implants, confirm the implant requests (with the reps), and submit
the instrumentation & equipment sheet (via email) to Mrs Linda Comeau (at the latest by
the Thursday before the Tuesday OR); the MDesk template and implant choice are
usually reviewed informally the week before the Tuesday/Thursday OR on
Monday/Tuesday/Wednesay while walking back to Dr Malchau’s office after morning
conference
Implant Selection:
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RSA cases: Biomet Regenerex Cup, E poly, Taperloc Stems; with tantalum
beads
Primary hips:
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Smith & Nephew R3 cups and Spectron (cemented) or Synergy (uncemented)
stems; Zimmer ML taper or Biomet taperloc stems PRN depending on the
templating
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Smith & Nephew Birmingham Resurfacing; always also template the femur with a
Synergy stem for contingency should the resurfacing procedure be aborted
Revision Hips:
Smith & Nephew Spectron primary or revision long-stem (cemented)
Stryker Restoration or GMRS tumour prosthesis systems
Depuy SROM
Allograft struts with cables
Cobalt cement on ice
Post-operative protocol
Drains & catheters out POD1; DVT prophylaxis with LMWH for 10 days postop;
generally WBAT, but should confirm for patients who have had hip resurfacing
Appendix
MDesk Computer Templating
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Save image (that contains marker ball) as JPeg file
Open MDesk and select ‘New Session’ under ‘File’
Open pelvis radiograph
Select ‘Tools’, then choose ‘Open measuring guide’; then select ‘calibration’
(sphere scaling – 30mm)
Select ‘Tools’ again and choose ‘Open measuring guide’ once more; but then
select ‘basic-Pelvis.mmg Preoperative Planning’ (1st column, 2nd row)
Follow instructions on side-bar afterwards; user can go back by choosing ‘Undo’
under ‘Edit’ tab; and then choose ‘Play’ on side-bar to resume templating
Print image in landscape format for reference
Implant Reps
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Zimmer
Ed Mahoney (617 538 4560)
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Biomet
Vince Palmer (781 799 6533)
John McDonough (617 640 3833)
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Depuy
Lou Silva (781 764 5626)
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Stryker
Ed McVeigh (617 413 3525)
John Sheehan (781 964 4334)
Discharge Summary Templates
Please call Dr Malchau, your PCP or report to the Emergency Department if you have
any nausea, vomiting, fever greater than 101.5, swelling, chest pain, shortness of
breath, increased pain/redness/drainage from your incision sites, numbness/tingling, or
any other concerning symptoms.
ACTIVITY: Weight-bearing as tolerated.
MEDICATIONS: Take all medications as prescribed and resume home medications.
Take a stool softener if taking narcotic pain medications. Stool softeners work better if
you drink adequate amounts of fluid, ideally water. Try and drink 6-8 glasses of water a
day, unless otherwise contra-indicated. If you are taking a stool softener but have not
had a bowel movement in 3 days, please call the office and we will recommend
alternatives. Taper down pain medication use as tolerated. No driving or operating
heavy machinery while using narcotic pain medications.
ANTICOAGULATION: Common symptoms of DVT/blood clots include: Localized pain,
swelling, calf tenderness, redness or discoloration of the skin. PE symptoms include:
shortness of breath, rapid pulse, sweating, chest pain that worsens with inspiration,
coughing up blood, light headedness, feelings of apprehension. If you experience any of
these symptoms call the office or go to the closest Emergency Department.
WOUND CARE: Keep your incision clean and dry. You can shower but should not tubbath or submerge your incision. Prior to any wound care please wash and dry your
hands. Place a dry sterile dressing over the wound each day if there is drainage,
otherwise you can leave it open to air. The visiting nurse or rehab facility can remove
the staples on post-op day 14 and place steri-strips across the wound. Leave the Steristrips in place until they fall off on their own.
Walker or Crutches for ambulation.
Please follow-up with Dr Malchau at the orthopaedic clinic in about 5-6 weeks from the
date of surgery; call Mrs Linda Comeau at 617-643-1322 to make an appointment.