Floyd Landis' Hip Battle

Doctors Explain Why The Tour De France Winner Needs Hip Surgery

(WebMD) 
More importantly, however, when treated early on, it's possible to minimize the damage caused by this condition and put off, or even prevent, the need for a hip replacement.

One solution is a surgery Urbaniak developed in 1979 known as a "free vascularized fibular graft" (FVFG). In this procedure, he says, bits of bone and blood vessel are grafted from the lower leg and implanted into the area where circulation is compromised.

"It works in over 80% of patients -- and it can usually hold off a hip replacement for eight or 10 years, or sometimes indefinitely," says Urbaniak.

While there are no established drug treatments for osteonecrosis, NONF reports some medications are showing promise. They include bisophosphonates (used to treat the bone thinning disorder osteoporosis), drugs used to treat high blood pressure, as well as certain cholesterol-lowering and anticlotting medications.

Can Landis Return to Racing?

While no one is certain why Landis didn't treat the problem early on, what remains is his immediate need for hip replacement surgery.

And while the operation will clearly alleviate his pain, the question on everyone's mind is will it prevent him from returning to cycling.

Surprisingly, most experts say not only will he be able to ride competitively again, he could be back in the hot seat just months after surgery.

"Patients are out of the hospital in three days, on crutches for two weeks, using a cane for two to four weeks, which brings you to about a six-week recovery time," says Bronson.

At that point, he says, they are free to begin working out with exercises like swimming and riding a stationary bike.

"As long as there is no pounding on the joints, it's safe to begin activity," says Bronson. — And while he says outside bike riding is discouraged for three months because of the risk of falling, after that, regular cycling is not only allowed, it's encouraged.

"I would say that he could be back competing within six months," says Bronson.

Urbaniak agrees: "The prognosis for returning to competitive cycling is good. We let people get on the bike for rehab a few weeks after a total hip replacement and I would guess he could start back training again in six weeks or less, and competing within several months after that."

Long-Lasting Hip Replacements

Some doctors say that Landis' new hip may last for many years – even if he continues to compete.

"A hip replacement used to have a life of 15 years or less, before it had to be replaced again, but now they are lasting up to 30 years. So depending on the age when it's done, a patient may never need another surgery," says Bronson.

Urbaniak is slightly more conservative, estimating around a 20- to 25-year lifespan for Landis' new hip, but says it's not so much the years, as what it is you do during that time that matters most.

"The relationship of activity to longevity is more important than age," he says.

But what about an active athlete like Landis? Doctors say that cycling won't put any undue stress on his new hip, so there's no fear of wearing it out too soon.

"If he was a triathelete -- and part of his training was running -- that would be a different story. But cycling does not cause pounding, and it's really only the pounding that has detrimental effects," says Bronson.

So maybe after the next win, Landis will be going to Disney World after all.

SOURCES:: James Urbaniak, MD, professor, orthopaedic surgery, Duke University Medical Center, Durham, N.C. Michael Benson, MD, chief, joint replacement surgery, Mount Sinai School of Medicine, New York City; Questions and Answers About Osteonecrosis, NIAMS, March, 2006; Osteonecrosis, The National Osteonecrosis Foundation. Rosen, K, Landis Hip To Defending Tour De Georgia Title, The Atlanta Journal-Constitution, July 25, 2006. ABC News web site: "Can Landis Pull a Lance Comeback?"