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Cancer survivor avoids hip replacement with innovative procedure

Ashley Fisher’s osteonecrosis called for two hip replacements, but an innovative procedure saved her left hip.
Ashley Fisher’s osteonecrosis called for two hip replacements, but an innovative procedure saved her left hip.

Core decompression with biologic augmentation was the answer Ashley Fisher needed for her ongoing hip issues, including osteonecrosis.

Imagine you’re 21 years old and you’ve already had your right hip replaced. The severe pain in your left hip indicates it may be time for yet another replacement. But two hip replacements before the age of 25? Huntington Hospital’s chair of orthopedics, James Gurtowski, MD, helped one Brentwood woman avoid that fate.

Then 17-year-old Ashley Fisher was brushing off her severe migraines. She figured it was normal to struggle with bad headaches every day. It wasn’t until she noticed things like drinking a lot of water would cause her terrible pain that she finally decided it was time to see a doctor.

Ashley was right to listen to her gut. At Cohen Children’s Medical Center she was diagnosed with chondrocarcoma, a cartilage cancer. Three calcified tumors at the base of her sinus were going into her cranium. Given the placement and severity of the tumors, Cohen Children’s Steven Schneider, MD, a pediatric neurological surgeon, was surprised she was still alive. Dr. Schneider performed three brain surgeries to remove the tumors.

After her recovery at Cohen Children’s, Ashley was finally able to go home and, with the help of her teachers who home-schooled her, she graduated from Brentwood High School on time.

A new pain, a new diagnosis

Ashley was attending SUNY New Paltz when she began experiencing a new set of symptoms — this time, originating from her hips. At the store where she was working part time, she was in too much pain to unload boxes and climb up and down ladders.

After an MRI, it was determined that Ashley had osteonecrosis, or dead bone, in her hips, a side effect of the high-dose steroids she had been put on as part of her cancer treatment. The severity of the damage in her right hip resulted in a total hip replacement performed by Dr. Gurtowski at Huntington Hospital. Ashley was 20 years old.

quotation mark I am so grateful. Dr. Gurtowski went above and beyond his call of duty as a doctor and as a person [to save my hip].
Ashley Fisher

A novel procedure

In an effort to preserve her left hip, which had not been as severely affected, Dr. Gurtowski decided to perform a new procedure at the hospital known as core decompression with biologic augmentation.

In this first-of-its-kind surgery at Huntington Hospital, Dr. Gurtowski and his team removed decaying bone from Ashley’s hip and harvested mesenchymal stem cells from healthy bone marrow in her pelvis. The stem cells were concentrated in a centrifuge and then reimplanted into the bone using a PerFuse Percutaneous Core Decompression System, which was brought in specially to make this innovative procedure possible. The cells were then sealed in with a calcium phosphate bone substitute material in a technique known as a subchondroplasty.

Dr. Gurtowski’s goal with this approach was to stop her bone from decaying, or at the very least, delay a future hip replacement.

Since the core decompression procedure is minimally invasive and was performed through an incision smaller than two inches, Ashley was able to recover with less pain than she experienced with her hip replacement. After her hip replacement, she needed pain medication for three weeks; with core decompression, she only needed it for three days.

“I am so grateful,” Ashley said. “Dr. Gurtowski went above and beyond his call of duty as a doctor and as a person [to save my hip].”

After about two months, Ashley was walking without the assistance of crutches. She has returned to finish her last year at SUNY New Paltz.

As a cancer survivor, Ashley seeks to raise awareness about her form of cancer and other underrepresented, underfunded forms of cancer. She hopes to join the Peace Corps and then become a pediatric oncology researcher and teach.

After her experiences, Ashley would tell her 17-year-old, recently diagnosed self, “Don’t ignore the pain. Pain is your body’s way of telling you that something is wrong. Don’t blindly trust the Internet. Ask a doctor, because mine saved my life.”

Ashley’s walk across the stage this May as she graduates will hold extra special meaning, thanks to Dr. Gurtowski.