New joints allow teen cancer survivor to walk again

Cancer treatment rid Trinity Goodson’s body of non-Hodgkin lymphoma, but left her unable to walk — let alone dance. Thanks to a new hip and a knee specially made to accommodate a growing teen, Trinity danced at prom.

It was prom, and Trinity Goodson felt like a princess. The Pekin, Indiana, junior spent the day perfecting her nails, makeup, and hair. After she posed for pictures, she headed to the car for a night of fun and dancing. Just a year ago, this evening would have been impossible.

Trinity, now 17, hasn’t had the usual teenage experience. In 2012, she was diagnosed with non-Hodgkin lymphoma, a cancer that attacks various parts of the body through the immune system.

Laura Goodson, Trinity’s mom, still remembers the day her daughter was diagnosed.

“It felt like a nuclear bomb had fallen on top of us,” Laura said.

Trinity immediately started treatment at Norton Children’s Cancer Institute, affiliated with the University of Louisville. After a year, the cancer was in remission, but returned a month later. Trinity received a bone marrow transplant, which helped eliminate the cancer in 2014. Trinity now is classified as cured, but she still sees doctors at Norton Children’s every three months.

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“We’re always wondering if the cancer will come back,” Laura said.

Bones of a 75-year-old

The cancer and necessary treatment wreaked havoc on Trinity’s bones. She developed avascular necrosis (AVN) — some of her bone tissue died due to lack of blood flow. Complications often include collapse of the bone or nearby joint surface. The condition can leave a person unable to walk.

“Doctors told us Trinity had the bones of a 75-year-old woman,” Laura said.

For Trinity, the AVN caused her right knee to bow severely inward. It also destroyed her hip. Instead of her hip being in the normal round shape, it had completely collapsed – shortening her leg and causing severe pain when walking or turning the leg at in any direction.  The cancer was gone, but now the teen couldn’t walk. By late 2017, she was using a wheelchair to get around.

“After all I had gone through, being stuck in a wheelchair was so hard,” Trinity said. “I felt like I was tied down.”

Finding a way to walk again

Trinity was down but not out. The family turned to Jennifer M. Brey, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville. Dr. Brey performed a scope procedure on Trinity’s knee, but it became clear that at least part of the knee would need to be replaced.

Dr. Brey referred Trinity to Joseph W. Greene, M.D., orthopedic surgeon with Norton Orthopedic Institute. Dr. Greene specializes in knee and hip replacements.

“Trinity was a very complicated case,” Dr. Greene said. “But she really needed some help in restoring the function of her joints.”

The first part of treatment was to replace Trinity’s hip.

Last year, Dr. Greene performed a successful hip replacement. Trinity went home the next day and was back at school in just a few weeks. She was feeling better but still couldn’t walk — her knee was too damaged from the necrosis.

“My knee was so heavily bent, I couldn’t really put any weight on it,” Trinity said.

Dr. Greene recommended a partial knee replacement, which would be even more complicated than the hip replacement. Trinity was still growing, and replacing the knee could damage a major growth plate.

“Most people in need of replacements are well past the growing stage of their lives,” Dr. Greene said. “We wanted to get Trinity walking again but also make sure her legs would grow to the same length.”

To help Trinity, Dr. Greene ordered a custom implant. The device, which took nearly eight months to make, was designed to support the knee without impacting the growth plate.

“The implant allowed for the bone to grow into it,” Dr. Greene said. “This was pivotal in her recovery and ability to walk long term.”

In the late fall, Dr. Greene replaced Trinity’s knee. The impact was almost immediate. Hours after her surgery, Trinity was on her feet with the help of a walker — the first steps she had taken in almost a year.

“I remember looking down at my knee and I started crying,” Trinity said. “It was straight for the first time in years.”

Getting back on her feet

With intense rehab and support from family, Trinity became steadier on her feet. In less than two weeks, she graduated from the walker to a cane. Now, she’s walking on her own. She even can do some bike riding.

“I’m so happy not to be tied down anymore,” Trinity said.

Bright future ahead

After more than seven years of medical challenges, Trinity is ready to take on the future. Following graduation, she wants to spend a year doing photography and then enroll in college to become a fashion or interior designer. Her experience has given her wisdom often reserved for people much older.

“I’ve realized how strong I am and that I can tackle anything,” she said. “I also have great people around me.”

Dr. Greene is one of those people.

“He got me walking again,” Trinity said. “He genuinely wanted to help me. It was like we were on the journey together, and for that I’ll always be grateful.”


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