M Røkkum

Oslo University Hospital, Oslo, Oslo, Norway

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Publications (46)35.86 Total impact

  • Ole Reigstad, Magne Røkkum
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    ABSTRACT: Conversion of a failed total wrist arthroplasty to arthrodesis can be difficult. A custom-made titanium alloy peg was constructed to enable arthrodesis with the original arthroplasty components in situ. Two out of three patients were especially challenging cases with little bone available. Bony union was achieved in 2 to 3 months. The peg simplified a difficult revision situation and gave good, predictable results at follow-up.
    Journal of wrist surgery. 08/2014; 3(3):211-5.
  • Ole Reigstad, Magne Røkkum
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    ABSTRACT: Earlier generations of wrist arthroplasty were limited to low demand patients. Bone fixation problems, excessive wear, and adverse designs resulting in loosening, imbalance, and dislocation led to the withdrawal of a number of models. Contemporary wrist prostheses aim at replacing wrist arthrodesis in the majority of patients with radiocarpal destruction, including high demand cases. Contraindications are wrist imbalance, insufficient soft tissue, or bone stock and infection. Various designs, fixation principles, bearing materials, and articulations have been employed. Some of the devises (RE-MOTION(TM), Motec(®)) demonstrate promising short- to midterm results, and calls for cautious optimism.
    Hand Surgery 01/2014; 19(2):311-22.
  • István Zoltán Rigó, Magne Røkkum
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    ABSTRACT: We compared the results of two methods for reinsertion of flexor digitorum profundus tendons retrospectively. In 35 fingers of 29 patients pull-out suture and in 13 fingers of 11 patients transverse intraosseous loop technique was performed with a mean follow-up of 8 and 6 months, respectively. Eleven and nine fingers achieved “excellent” or “good” function according to Strickland and Glogovac at 8 weeks; 20 and ten at the last control in the pull-out and transverse intraosseous loop groups, respectively. The difference at 8 weeks was statistically significant in favour of the transverse intraosseous loop group. Ten patients underwent 12 complications in the pull-out group (four superficial infections; one rerupture, one PIP and one DIP joint contracture, one adhesion, two granulomas, one nail deformity and one carpal tunnel syndrome) and four of them were reoperated (one carpal tunnel release, one teno-arthrolysis and two resections of granuloma). There was no complication and no reoperation in the transverse intraosseous loop group, the difference being statistically significant for the former. In our study the transverse intraosseous loop technique seemed to be a safe alternative with possibly better functional results compared to the pull-out suture.
    Journal of Hand and Microsurgery. 12/2013;
  • István Z Rigó, Magne Røkkum
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    ABSTRACT: Abstract Arthrodesis of the thumb metacarpophalangeal (MP) joint exhibits good results in rheumatoid patients but is controversial in post-traumatic conditions. This study evaluated the subjective outcome after thumb MP joint arthrodesis in chronic injuries and non-rheumatoid degenerative disorders. Forty-six patients were evaluated retrospectively with a mean follow-up of 4.1 years (range 1.5-6.5). Both the Quick DASH score (mean 18.6; range 0-72.7) and Visual Analogue Scales (satisfaction, pain, stiffness, and impairment of ADL; mean 3.2, 3.0, 3.0, and 2.5; range 0-9.6, 0-9.1, 0-9.8, and 0-9.6, respectively) showed wide variations. Twelve patients regretted the operation and 37 experienced difficulties with one or more specific activities. Multiple regression analyses indicated that elderly patients with painless instability are the best candidates for thumb MP joint arthrodesis. In young patients with excessively painful thumb MP joints and involvement in Workers' Compensation Board claims, but without advanced degenerative changes, this study recommends avoiding arthrodesis and considering alternative treatment modalities. The importance of adequate preoperative information about the realistic expectations after arthrodesis of the thumb MP joint is emphasised.
    Journal of plastic surgery and hand surgery. 02/2013;
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    ABSTRACT: Trapezium components from two uncemented total joint replacements were compared in a three-dimensional finite element model. A 100 N axial and angular load was applied in a normal and an osteoporotic bone model. The axial deformation and maximum periprosthetic stress are greater for the Elektra(TM) than the Motec CMC(®) cup. The Motec CMC(®) design is less sensitive to changing bone quality. The Elektra(TM) cup transmits more stress to the cortical bone rim in all load conditions, but under angular loading the proportionate increase in stress is lower. The Motec CMC(®) design distributes the stress and contact pressure more evenly, whereas the Elektra(TM) transfers most of the load to the cortical bone rim and the screw hole base. The design features that are believed to be of greatest significance for the differences are the raised centre of rotation of the Motec CMC(®) cup and the collar acting as a lever arm.
    Hand Surgery 01/2013; 18(2):221-8.
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    ABSTRACT: The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty was implanted in 16 wrists with scaphoid nonunion advanced collapse (SNAC; grades 3 or 4) and 14 wrists with scapholunate advanced collapse (SLAC) in 30 patients (20 men) with severe (grades 3 or 4) post-traumatic osteoarthritis of the wrist. The mean age of the patients was 52 years (31 to 71). All prostheses integrated well radiologically. At a mean follow-up of 3.2 years (1.1 to 6.1) no luxation or implant breakage occurred. Two wrists were converted to an arthrodesis for persistent pain. Loosening occurred in one further wrist at five years post-operatively. The remainder demonstrated close bone-implant contact. The clinical results were good, with markedly decreased Disabilities of the Arm Shoulder and Hand (DASH) and pain scores, and increased movement and grip strength. No patient used analgesics and most had returned to work. Good short-term function was achieved using this wrist arthroplasty in a high-demand group of patients with post-traumatic osteoarthritis.
    Journal of Bone and Joint Surgery - British Volume 11/2012; 94(11):1540-5. · 2.69 Impact Factor
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    ABSTRACT: Abstract There is a need for a strong suture technique that allows early active mobilisation after repair of flexor tendons, but the best method has not yet been found. The aim of this study was to compare the modified Kessler suture biomechanically with a newer, two-strand suture. Eighteen porcine tendons were cut and repaired according to either the grasping modified Kessler suture or the combined side-locking loop technique (Yotsumoto) and interlocking horizontal mattress suture (Dona). The specimens were tested linearly to failure. The 2 mm gap force, yield force, ultimate force, stiffness, energy to yield, and energy to failure were all significantly higher (p value = 0.005, 0.003, <0.001, 0.001, 0.004, and 0.001, respectively) in the Yotsumoto-Dona group (median values (IQR): 30.9 (28.1-39.5) N, 82.7 (64.9-114.1) N, 82.7 (76.6-114.1) N, 12.5 (10-14.5) N/mm, 0.45 (0.2-0.5) J, and 0.45 (0.35-0.5) J) than in the modified Kessler group (25.8 (12.2-28.1) N, 35 (24.6-54.4) N, 50.9 (34.4-55.1) N, 7 (5.8-91) N/mm, 0.09 (0.06-0.18) J, and 0.21 (0.18-0.28) J). All Yotsumoto-Dona specimens had a yield force exceeding 35 N, while in the Kessler group only four did. The early yielding rate was 6/9 and 2/9 in the modified Kessler and the Yotsumoto-Dona groups, respectively (p = 0.15). Most of the core sutures failed by breakage, but three Yotsumoto knots loosened. All the simple running and six of the Dona epitendinous sutures failed predominantly by pulling-out, and by breakage at the intersections in three of the latter. The relatively easy two-strand Yotsumoto-Dona suture is likely to withstand the loads of active finger flexion, whereas the modified Kessler suture is probably not.
    Journal of plastic surgery and hand surgery. 08/2012; 46(5):313-7.
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    ABSTRACT: OBJECTIVES:: Scaphoid non-union is relatively rare in children and adolescents, and no long-term follow-up has been reported. DESIGN:: retrospective follow-up study. PATIENTS:: Eleven patients (10 boys), mean 15.2 (13.9-15.9) years of age with scaphoid non-union and open growth plates were operated with bone grafting, Kirchner-wire fixation and 12 weeks of cast immobilisation. MAIN OUTCOME MEASUREMENTS:: Bony union, degenerative wrist changes and restoration of the carpal architecture was assessed with CT and radiographs. Clinical parameters included active ROM, grip strength, key pinch strength and subjective outcome scores (QDASH, VAS). RESULTS:: the patients were followed up after mean 6.9 (3.1-15.1) years, all attended. Radiographs and CT confirmed healing of all non-unions, the carpal anatomy was restored and the wrists were rated SNAC 0, without degenerative changes. The clinical result was excellent with VAS at rest = 1, at activity = 6 and QDASH score =3.3. Active ROM and grip strength were insignificantly reduced (14° and 2 kgs), the key pinch strength remained similar. CONCLUSION:: Healing of a scaphoid non-union can be expected in adolescents after open reduction, K-wire fixation, bone grafting and plaster immobilisation, resulting in pain relief and excellent wrist function without degenerative changes after longer term follow-up. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    Journal of orthopaedic trauma 08/2012; · 1.78 Impact Factor
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    ABSTRACT: Bio-medical implants release metallic elements during the long periods of time while inserted in the human body. The chemical interactions between the tissues and surface of the implants, and the mechanical friction of implants cause the release of metals into the human tissues. In this study we investigated the distribution and the chemical-state of the metallic elements in the tissues around a failed implant system using PIXE (proton induced x-ray emission) and SR-XRF (synchrotron radiation x-ray fluorescence) spectroscopies. The specimens were from the cases of patients with diagnosed arthritis. The implant consisted of a stem and a metal backing made of Ti-6Al-4V, an implant head made of stainless steel, and a polyethylene (PE) cup. Both the stem and the metal backing had a plasma-sprayed HAp surface coating. Distribution and concentration of dissolved elements in tissues surrounding implants were examined and quantified using PIXE analysis. Similar specimen from the same case was further investigated using SR-XRF analysis. Chemical-states of the dissolved elements ware also studied by XAFS (x-ray absorption fine structure) analysis. From results of these measurements, it is confirmed that the tissues surrounding implants contained metallic elements such as Fe, Cr, Ni, and Ti. These elements are originated from the implant. Furthermore, it was made clear that the chemical-state of Fe had changed as a consequence of dissolution of Fe in the organic tissues.
    International Journal of PIXE 04/2012; 10(01n02).
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    ABSTRACT: Scaphoid injury and subsequent non-union is a well documented and researched subject. This article gives an overview of the epidemiology and results of the patients we have treated for scaphoid non-union at a University Hospital. 283 scaphoid non-unions in 268 patients (83% men) were operated upon, 230 as a primary and 47 as a secondary. The median age at time of surgery was 27 years. One-third of the non-unions were located in the proximal part of the scaphoid and the remaining two-thirds in the middle part. Of the 146 patients (55%) who contacted a doctor at the time of injury, 53 fractures where diagnosed (20%). Fourteen (5%) were operated primarily while 39 (15%) (seven dislocated) were immobilized in plaster casts. Thirty-two (12%) were under the age of 16 at the time of injury. The average time from the injury to the initial non-union surgery was 1.5 years with 2.8 years to the second procedure. The risk of osteoarthritis increased time from injury to surgery (both primary and secondary procedures). The greatest potential for the reduction of scaphoid non-union is an increased awareness amongst younger men. There is also potential for improved accuracy in the diagnosis of scaphoid fractures (better clinical tests, the use of radiographs, CTs and MRIs) in order to identify the fracture and evaluate dislocation at the initial injury. Early diagnosis and treatment of fractures and non-unions will reduce the development of degenerative wrist changes.
    Hand Surgery 01/2012; 17(3):331-5.
  • Arild Aure, Karl R Hetland, Magne Rokkum
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    ABSTRACT: Posterior sternoclavicular dislocation is a rare injury that involves a risk of concomitant injuries to mediastinal structures. We report a 23-year-old man who underwent open reduction and fixation with a plantaris tendon graft after 13 weeks. The clinical and radiologic outcome was good.
    Journal of orthopaedic trauma 10/2011; 26(4):e33-5. · 1.78 Impact Factor
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    ABSTRACT: Untreated scaphoid nonunions are a hazard to the wrist, resulting in deteriorating function and radiologic degenerative changes with increasing time. Long-term results after surgery of scaphoid nonunion reporting clinical, radiologic, and subjective outcomes are scarce. Retrospective follow-up study. From 1990 to 1998, 53 patients were operated on for persistent scaphoid nonunion; three patients were excluded from the follow-up (one expelled foreigner, another died of an unrelated cause, one never appeared after surgery), leaving 50 patients eligible for follow-up. All patients were operated on with open reduction and internal fixation; the majority also received a bone graft. Radiology and computed tomography verified union, degenerative wrist changes, and final salvage treatment. Range of motion, grip strength, key pinch, and subjective outcome (QuickDASH, visual analog scale). Fifty patients were followed up after a mean of 12.2 years (standard deviation [SD], 3.0), 47 by clinical and radiologic examination; three were interviewed by telephone and completed QuickDASH and visual analog scale forms. Union was achieved in 45 of 50 scaphoids and an additional two after a second attempt. Five patients (one persistent and four healed nonunions) underwent salvage procedures. Grip strength (41 vs 45 kg, P = nonsignificant), key pinch (11.5 vs 12.4, P = nonsignificant), and active range of motion (186° vs 214°, P < 0.001) were slightly reduced compared with the uninjured side. The subjective outcome was good (mean visual analog scale = 7, mean QuickDASH = 9.1). Minor degenerative changes were seen in nine wrists at surgery and 22 at follow-up. Healing of a scaphoid nonunion provides long-term pain relief, excellent wrist function, and halts degenerative changes in the majority of patients. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    Journal of orthopaedic trauma 09/2011; 26(4):241-5. · 1.78 Impact Factor
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    ABSTRACT: Applying bioactive coatings on orthopedic implants can increase the fixation and long-term implant survival. In our study, we compared a resorbable electrochemically deposited calcium phosphate coating (Bonit®) to a thin (40 μm) plasma-sprayed hydroxyapatite (HA) coating, applied on grit-blasted screw-shaped Ti-6Al-4V implants in the cortical region of rabbit tibia, implanted for 6, 12, and 52 weeks. The removal torque results demonstrated stronger bone-to-implant fixation for the HA than Bonit-coated screws at 6 and 12 weeks. After 52 weeks, the fixation was in favor of the Bonit-coated screws, but the difference was statistically insignificant. Coat flaking and delamination of the HA with multinucleated giant cell activity and bone resorption observed histologically seemed to preclude any significant increase in fixation comparing the HA implants at 6 versus 12 weeks and 12 versus 52 weeks. The Bonit-coated implants exhibited increasing fixation from 6 to 12 weeks and from 12 to 52 weeks, and the coat was resorbed within 6 weeks, with minimal activity of multinucleated giant cells or bone resorption. A different fixation pattern was observed for the two coatings with a sharper but time limited increase in fixation for the HA-coated screws, and a slower but more steadily increasing fixation pattern for the Bonit-coated screws. The side effects were more serious for the HA coating and limiting the expected increase in fixation with time.
    Journal of Biomedical Materials Research Part B Applied Biomaterials 06/2011; 99(1):14-20. · 2.31 Impact Factor
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    ABSTRACT: Wrist prostheses have never achieved the sort of clinical outcomes found with those of hips and knees. We have developed a novel uncemented modular wrist prosthesis with screw fixation, metal-on-metal coupling, and ball-and-socket articulation. Eight patients admitted for wrist arthrodesis to treat primary or secondary osteoarthritis (not rheumatoid) were operated on. The prosthesis reduced the amount of bone removed and spared the distal radioulnar joint. After 7 to 9 years we found that the fixed centre of the ball-and-socket articulation provided good stability and mobility, and relief of pain and grip strength were satisfactory. We saw no luxations, metacarpal fractures or cut-outs, or mechanical failures of the implants. Two distal screws loosened (revised with new distal screws), and one early inflammation and one late infection occurred (revised to arthrodesis). We propose modifications to the implant with reduction in the diameter of the screws and the height of the threads, and rounding of the distal tip. The technique should include release of the third carpometacarpal joint, alignment of the capitate and the third metacarpal, and arthrodesis of the joint with bone chips.
    Journal of plastic surgery and hand surgery. 06/2011; 45(3):148-56.
  • Mona I Winge, Olav Reikerås, Magne Røkkum
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    ABSTRACT: Donor site morbidity is a problem after autologous bone transplantation. An injectable CaP bone cement indicates properties similar to bone. Double osteotomies on rat tibias were performed. The intercalated segments were avascular (10), vascular (10), or avascular with Norian SRS(®) CaP bone cement replacing cancellous bone (10). Controls were non-operated contralateral tibias (15). All osteotomies were stabilised with an intra-medullary nail. After 8 weeks, all rats were killed. The harvested tibias were compared using X-ray, DEXA scanning, microCT scans and a biomechanical torsional test. No difference in healing processes or biomechanical results has been found between the avascular bone graft, vascular bone graft and CaP bone cement groups. The injectable CaP bone cement confirms its similarities to bone, implying that it can be used as an adjunct to secure bone fragments and as a possible alternative to autologous bone transplantation in clinical practice.
    Archives of Orthopaedic and Trauma Surgery 02/2011; 131(8):1035-41. · 1.36 Impact Factor
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    ABSTRACT: Neurovascular injuries in children with dislocated supracondylar humeral fractures are not uncommon. Closed reduction and pin fixation usually will restore the circulation. In some patients, there is still compromised circulation and a neurologic deficit, and they are treated with open exploration and microvascular reconstruction. We have investigated the clinical and functional outcome more than 1 year after the injury in this most serious group of patients. Retrospective follow-up study. During 2001 to 2007, five patients were referred to our department with a pale, pulseless hand and circulatory impairment with absent or slow capillary refill after primary treatment with closed reduction and cross pinning at their local hospital for Gartland Type III supracondylar fractures. Two of the patients also had clinical signs of nerve injury. All were reoperated on with open exploration and release of the entrapped brachial artery. Vascular reconstruction was performed in four patients (vasodilating agent was sufficient in one patient) and release of the median nerve from the fracture in two. One of these two also had a Kirschner wire pierced through the ulnar nerve. All fractures were rereduced and cross-pinned. No intra- or postoperative complications were seen. OUTCOME/RESULTS: At follow-up more than 1 year after the injury, all patients exhibited normal and symmetric function in their upper extremities, including circulation, neurologic status, range of motion, grip strength, and key pinch strength. Clinical and radiologic appearance was normal. Pulseless arms after repositioning of dislocated supracondylar humeral fractures are a medical emergency. After open release and, if necessary, microvascular reconstruction of vessels and nerves, fracture reduction, and fixation, excellent clinical long-term outcome can be expected. The procedure can be carried out with a low rate of complications.
    Journal of orthopaedic trauma 11/2010; 25(1):26-30. · 1.78 Impact Factor
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    ABSTRACT: Untreated ununited scaphoid fractures are a hazard to the wrist because of increasing degenerative changes with time. We have treated 81 consecutive ununited scaphoid fractures by open reposition, autologous bone transplantation, and Kirschner wire fixation, 2.7 years after the primary injury. Sixty-nine were men and the mean age at operation was 29 (range 15-71) years. Anatomy of the wrist was restored and radiological healing confirmed in 72/81 patients. There were two deep infections, and the fractures did not heal. Patients with moderate preoperative arthritic wrist changes (scaphoid non-union advanced collapse (SNAC) stage 2) or ununited fractures of the proximal 1/6 of the scaphoid had worse healing than the remainder. Two of nine scaphoids that did not heal were reoperated on with autologous bone grafting and fixation with screws or pins, both of which healed successfully. Three salvage procedures (two wrist arthrodeses and one four corner fusion) were done and the remaining four declined further treatment. Our overall results are comparable to results published where alternative fixation methods have been used. We find that our standard method using Kirschner (K) wires and bone grafting is reliable and inexpensive for most scaphoid pseudarthroses and our results are comparable to published results when alternative fixation methods have been used.
    Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 02/2010; 44(2):106-11. · 0.94 Impact Factor
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    ABSTRACT: Eighteen patients who underwent revision non-vascularized bone grafting and internal fixation after failed surgery for scaphoid nonunion were reviewed after a minimum of 8.2 years. Eleven of the nonunions were located in the middle and seven in the proximal third of the scaphoid. The mean interval between injury and the revision procedure was 6 years. Sixteen of the 18 nonunions healed, two after a third attempt. Three patients with healed nonunions and one patient with persistent nonunion required salvage procedures for progressive radiocarpal arthrosis. In the remaining 14 cases, the mean loss of wrist flexion/extension arc compared to the contralateral wrist was 36 degrees . Mean reduction of grip strength and key pinch was 9.3 kg and 0.9 kg respectively. The QuickDASH score was 18 and a visual analogue pain score was 21/100 at follow-up. Wrist degeneration increased in all but one case during the observation period. Thirteen of 16 patients with union and one patient with a persisting nonunion experienced moderate symptoms.
    The Journal of hand surgery, European volume. 09/2009; 34(6):772-7.
  • Source
    Astor Reigstad, Magne Røkkum
    07/2009; 63(4):465-466.
  • Source
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    ABSTRACT: The long-term results of uncemented total hip arthroplasties vary widely due to differences in design, metal alloy, coating, surface structure, and porosity. We retrospectively studied 75 cementless Zweymuller SL stems in combination with Endler titanium-backed threaded cups (Z-E) in 70 patients. 35 patients were women, and the mean age at surgery was 52 (24-68) years. 16 patients died and 1 emigrated, 7 patients (of which 1 later died) subsequently underwent revision, and the remaining 47 patients with 50 original arthroplasties were followed up after a median of 16 (15-18) years. Revision of 8 hips resulted in an 18-year Kaplan-Meier estimated overall survival rate of 88% (CI: 79-96). 6 of 7 cup revisions were due to liner wear and osteolysis, and 1 was due to aseptic loosening. 2 of 3 stem revisions were due to femoral loosening and 1 was due to fracture of the neck of the stem. The clinical results were good, with a mean Harris hip score of 89 (54-100). Half of 70 hips in 65 patients had ectopic bone formation. All unrevised implants were radiographically stable, with a mean liner wear of 0.07 mm/year. These long-term results demonstrate that the combination of a Zweymuller SL stem and an Endler titanium-backed screw cup is a good hip arthroplasty in young and active patients. A prefixed polyethylene liner is a drawback, necessitating exchange of the whole cup in cases with polyethylene wear.
    Acta Orthopaedica 05/2008; 79(2):194-202. · 2.74 Impact Factor

Publication Stats

344 Citations
35.86 Total Impact Points

Institutions

  • 2011–2013
    • Oslo University Hospital
      • Department of Orthopaedic Surgery
      Oslo, Oslo, Norway
  • 2001–2012
    • University of Oslo
      • • Department of General Internal Medicine
      • • Department of Orthopaedics (ORTHO)
      Kristiania (historical), Oslo County, Norway
  • 2009
    • University of Birmingham
      Birmingham, England, United Kingdom
  • 2008
    • Haukeland University Hospital
      Bergen, Hordaland, Norway
  • 2002
    • Monash University (Australia)
      • Department of Materials Engineering, Clayton
      Melbourne, Victoria, Australia