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Revolutionary shoulder procedure a first in San Diego

Since the curve of an ankle joint makes for a great fit, doctors decided to use a donor’s ankle for Rose's shoulder.

SAN DIEGO — Rose Truong’s story may make you re-think the order of the children’s song “Head, Shoulders, Knees and Toes.”

“It was really depressing for a while,” Truong said.

Truong was in her late 30’s and a newlywed when her shoulder pain got worse. “I was told to stretch it out and kind of manage the pain,” Truong said.

Rose’s doctor at the time chalked it up to the rigors of long hours working on the computer and aging.

Then last October, the pain got so bad, Rose couldn’t even open a bottle of water. She switched health care providers and was referred to Scripps MD Anderson Orthopedic Surgeon, Dr. Anna Kulidjian.

“We looked into it further and discovered she had a rare form of bone cancer, called chondrosarcoma. That young of an age, that particular cancer never happens,” Dr. Kulidjian said.

Easy to spot on x-rays, the tumor was larger than a golf ball and was lodged in Rose’s shoulder socket.

“I was like how can I possibly have cancer,” Rose said sadly.

The process of removing the tumor typically leaves patients with no use of the shoulder.

That was tough news for Rose, who enjoys bowling, crafting and cooking. Rose was determined to beat the cancer and put her faith in Dr. Kulidjian.

“I just told her whatever you need to do, whatever instruction, I will follow, but you got to do something,” Rose exclaimed.

“I think when you see the eyes of the person standing in front of you, and there is the absolute realization that their life will be forever changed if you don’t come up with something, you have to come up with something that was better than yesterday,” Dr. Kulidjian said.

So Dr. Kulidjian plotted out a plan with fellow orthopedic surgeon Dr. Heinz Hoenecke, who specializes in shoulder injuries.

“Thinking outside the box, we actually adapted a sports medicine technique we use for athletes,” Dr. Hoenecke said.

The two Scripps Clinic surgeons teamed up with Dr. Darryl D’Lima, Research Director at the Shiley Center for Orthopedic Research and Education (SCORE) at Scripps Clinic.

Dr. D’Lima created a 3D computer model of Rose’s joint structure. The valuable images gave surgeons critical information on where to cut and how much bone to take during the procedure.

 “It allows you to see where the actual socket is involved,” said Dr. Kulidjian while holding the model.

In an animation provided by Scripps, you can see how large Rose’s tumor is. It was so big surgeons had to remove her shoulder socket.  

Since the curve of an ankle joint makes for a great fit, doctors decided to use a donor’s ankle. They re-shaped that donor’s ankle bone and it fit Rose’s shoulder perfectly.

However, doctors still had another challenge... How to attach the bone.

Doctors used a newly invented suture called a ‘tightrope’. “It’s a couple of buttons with sutures between them, it allowed us to compress bone, where a screw may not hold,” Dr. Hoenecke said.

The plan, a first in San Diego to treat this type of bone cancer, worked.

“It’s very unique, it opens the door for us to continue to think outside of the box to solve problems,” Dr. Hoenecke said.

One year later and Rose now has 90% mobility of her shoulder and can nearly lift her arm above her head.

Along with quite a scar, Rose admits she has quite a story to tell.

“Head, shoulders, knees and toes, that song, no longer applies to me!” Rose said with a chuckle.

“She had that determination to do something more than what was in front of her, something more than the word cancer,” Dr. Kulidjian said, praising Rose for her courage.

“You can’t help be moved by the way she handled that,” Dr. Hoenecke said.

Rose has been cancer-free for one year. She’s back to cooking, and hopefully bowling soon. “I’m blessed to be able to do this much,” Rose said with a smile.

Rose says her situation highlights the need and critical role donors play. “That little donation could be life or death for somebody. This completely changed my life!”

If you’d like to learn more about how to become a donor, you can access the Donate Life California page here.

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