When Keilany Santos graduated early from high school, she thought she was getting a jump on adult life and was ready for the next chapter. What she didn’t realize is that her entire story was about to change. At just 17 years old, she was diagnosed with T-cell lymphoma, a type of cancer that affects white blood cells. Part of her treatment involved corticosteroids, or steroids, drugs that are highly effective at killing cancer inside T-cells. But Keilany wouldn’t know the drugs’ side effects until she finished treatment a few years later.

“I was running on the treadmill and I started to get quite a bit of hip pain,” she said. At first, she thought her workouts were too aggressive, but the pain didn’t fade even when she took a few days off. Checking in with her doctor, she found out she had a condition called avascular necrosis in both hips.

Also known as osteonecrosis, this issue happens when the blood flow to a bone or joint is reduced or cut off, resulting in deterioration of the bone tissue. Over time, that can lead to small fractures in the bone, followed by osteoarthritis. Keilany’s doctor told her that the steroids during cancer treatment likely caused the problem.

She was just 20 years old. Doctors recommended surgery aimed at stimulating the growth of new bone tissue, in the hope that her body would replace the damaged tissue over time. But it didn't work out that way. “The pain didn't go away at all, and it was affecting how much I could do,” Keilany explained. Hip replacement was the next step, but she was hesitant. “I thought life would be totally different if I had that procedure, almost like I would have to give up the life I knew. I thought: I'm so young, will this limit me from now on?” But when the pain not only persisted but worsened, she decided to take the leap after all.

Hip replacement is a standard treatment for late-stage avascular necrosis, and research says it’s 95% effective at relieving pain and restoring mobility. But Keilany was still worried that it would leave her with significantly reduced function for everyday tasks. Fortunately, her fears were alleviated after she met with Howard Goodman, MD, chief of musculoskeletal oncology at Northwell’s Orthopaedic Institute.

Thanks to his clinical background in treating cancerous and noncancerous tumors of the bones, Dr. Goodman had a deep understanding of how Keilany’s cancer and its treatment had led to the difficulty with her hip joints. “He was really nice and super supportive,” she said. “He explained everything to me in such a helpful way and that made me feel much better about getting the surgeries and recovering.”

Keilany’s first surgery, on her left hip, took place in March 2021. Dr. Goodman performed surgery on her right hip that October. To her surprise and relief, within a few weeks her pain was gone and she was walking normally. Physical therapy, also at Northwell, was a huge factor in a strong recovery. “They helped me build strength and they were really supportive,” she said. "If I hadn't gone to physical therapy, I don't think I would be where I am now, particularly with running.”

Keilany had loved running when she was younger, but thought it would be too hard on her hips to start back up. But her physical therapy team worked with her to develop leg strength so that she could run with less chance of injury. Before long, she was running 5Ks, and then worked up to 10Ks. Now, she's training for a half-marathon.

She’s also working through another challenge as a result of the steroids. A full-body scan revealed avascular necrosis in both shoulders, although it wasn’t causing any pain. Because she plays bass in a band, Keilany was concerned that she'd have to give up her beloved music, but Dr. Goodman referred her to another Northwell physician: orthopedic surgeon and sports medicine specialist Randy Cohn, MD. He performed a partial shoulder replacement and she went back to physical therapy to build strength again.

“It’s all still a process, but with these surgeries, I’ve been able to keep doing what I love the most,” Keilany said. “It’s not easy to be this young and getting joint replacements, but I feel very supported thanks to Northwell. I’m able to push myself while still having fun and enjoying my life.”