UTHealth Houston orthopedic surgeon helps gunshot victim walk again

In 2015, Orlando Rosales was washing his truck. Suddenly, a man approached him with a gun. Rosales didn’t have time to think about what was happening – his fight or flight response automatically kicked in.

“I took the fight back to him and we ended up fighting over the weapon, which led to him shooting me,” said Rosales, who was 30 at the time.

The bullet entered Rosales’ right leg and shattered his femur. He underwent an emergency and subsequent surgeries to try to stabilize the bone, but the bone failed to heal. He had osteonecrosis of the femoral head, meaning part of the broken femur died because it wasn’t getting enough blood. It left him with chronic pain, and the bullet was still embedded deep into nerves and muscle. Rosales was in a wheelchair for two years.

“It was after the second surgery that my physicians told me if it didn’t work, I just had one more go at it, which would be the total hip replacement,” Rosales said. “If my body didn’t take to that, I would not be able to walk again.”

When Rosales heard that, tears came to his eyes.

“Going through the surgeries, I felt frustrated,” Rosales said. “I kept doing everything right, like physical therapy, and it just wasn’t working out. As far as being wheelchair-bound, it’s just horrible. I couldn’t do anything for myself. I had to have people help me do everything, like get out of bed. It was just a miserable feeling.”

It became clear that Rosales would need a total hip replacement, so he was referred to Kenneth Mathis, MD, an associate professor and Memorial Hermann Chair in the Department of Orthopedic Surgery with McGovern Medical School at UTHealth Houston.

“If the bone dies, it can collapse, which is what happened,” Mathis said. “That meant he would need a hip replacement.”

During one of his appointments, Rosales told Mathis the police never caught the person who shot him.

“In my mind I thought, ‘If they never caught the guy, maybe the bullet would be helpful,’” Mathis said. “So, I told him, ‘I'm going to try to get the bullet as well.’”

Mathis said it was a difficult surgery and the bullet was hard to find because of the amount of damage and scarring.

“When you’re operating on someone who’s never had surgery or never had a gunshot wound, it’s textbook anatomy,” Mathis said. “You can see the muscles, the nerves, and the arteries, and you know where to go. When things have been blown up by a bullet, it’s like driving at night in the fog and your headlights don’t work. You kind of need to know where you’re going and travel slowly.”

After Mathis completed Rosales’ hip replacement, he was able to retrieve the bullet. Then, Mathis worked to get the bullet to the Houston Police Department.

“Previous doctors told me that the bullet would eventually push out through the skin within 10 years, but it being such a large caliber, I didn’t want that,” Rosales said. “But Dr. Mathis was able to get it out, and that led to an arrest, so I was ecstatic about that.”

On his birthday, which was the day after his surgery, Rosales said he received the best gift ever – he took his first steps in two years.

“Those first steps were like a miracle to me,” Rosales said. “I was very excited. I felt overwhelmed with emotion. I didn’t think that was going to happen, especially the next day.”

Years ago, designs for hip replacements would last only 10 or 12 years, according to Mathis. 

“A number of years ago, we made a huge leap in technology,” he said. “We changed the plastic, called polyethylene, by blasting it with radiation, which made it dramatically more resistant to wear. We have put hip and knee replacements in wear simulators and simulated up to 30 years of walking, and the devices look almost brand new. So, Rosales has one of those kinds of devices made with the modern, highly cross-linked, ultra-high molecular weight polyethylene.”

“I just want to let everyone know not to give up hope,” Rosales said. “With the technology coming out, it’s a huge game changer.”

He couldn’t return to his former occupation of a master machinist for an airplane manufacturer because of the inability to lift and carry heavy sheets of metal. A friend opened a dental center, and Rosales found that his skills running computer numerical- controlled mills for heavy things like jet landing gear translated to milling crowns. He loved it.

“I thought it was awesome to learn how to do that and help people feel confident about their smiles,” he said.

Rosales then joined a company in Colorado. When his manager there, William Darling, came to work at UTHealth Houston School of Dentistry in the Department of Restorative Dentistry and Prosthodontics, he recruited Rosales.

“Now I’m right here, part of the same family with Dr. Mathis,” Rosales said. “Now I feel like I’m contributing back in a good way, helping students and residents and having more direct contact with patients. I love helping others.”

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