Docs: He can ride again
By Cindy Stauffer
Lancaster New Era

Published: Jul 24, 2006 1:54 PM EST

LANCASTER COUNTY, PA - Is it even possible?

Can an elite athlete recover from a painful and debilitating injury?

Can Floyd Landis return to France next year after major surgery to scream up and down the Alps, chase down other cyclists in time trials and once more vie for the podium in the Tour de France cycling race?

Here’s a little hint: Hope he likes the color yellow.

Landis, a Conestoga Valley High School graduate from Farmersville, won this year’s race even though he was competing with a badly deteriorated right hip, which he broke in a 2003 fall from his bike.

During the race, the 30-year-old cyclist revealed the joint was in such poor shape that he would have to undergo hip replacement surgery, likely sometime this fall.

Landis has several factors in his favor as he looks ahead to future races, local orthopedic surgeons said today.

Normally, surgeons counsel hip replacement patients to avoid contact sports and activities such as competitive tennis after surgery.

Golf is OK. Walking is, too.

Turns out, so is biking, because it involves a repetitive motion, but not pounding or twisting moves like ones used in baseball or basketball.

Translation: He won’t suffer the same fate as Bo Jackson, a professional football and baseball player who never fully recovered after hip replacement surgery.

“He’s picked the right sport for joint replacement,” said Dr. Gerald Rothacker of Orthopedic Associates of Lancaster.

Landis has another major advantage as he heads toward surgery: he’s a freak of conditioning, so well-muscled and oxygenated that his power, measured by sensors mounted to his pedal cranks or wheel hubs, actually increased in the past year even with his injury, according to a recent story in the New York Times.

“He’s a world-class athlete,” said Dr. Thomas Westphal of The Westphal Group. “He’ll probably be on the road within four to six weeks (of surgery).”

Also consider this: it’s Floyd Landis we’re talking about here, the man who can barely walk due to his injury, who competed in constant pain, who even developed a strange, hunched position on his bike, nicknamed the “praying Landis,” to get the maximum bang out of his failing hip.

“His job is biking and he’s dedicated to that,” said Dr. Mark Perezous of the Lancaster Orthopedic Group. “I would have trouble ruling him out. Seeing his hip (in published X-rays), it’s amazing what he did.”

After his victory Sunday, Landis said he will do “whatever it takes” to return to the Tour next year.

“I’m a bit more relaxed (about the surgery) now with this victory,” he told Cycling News after the race. “It would have been much worse if I hadn’t won the Tour because of an accident or whatever. I certainly know that I’ll fight as long as it takes to come back next year, or the following year. Whatever it takes, I will do it to be here again, because it’s a dream to me.”

After falling from his bike while training in 2003, Landis developed a condition called osteonecrosis. Basically, that means that the hip joint starts to collapse as a result of the loss of blood supply to the bone, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

It’s a painful condition.

Perezous said patients describe the sensation as “catching, grinding or burning. It can be pretty severe.”

Landis initially had pins put in his hip and then had holes drilled into the bone, to replenish the blood supply. Hip replacement is the treatment of choice for the late stages of the condition, which Landis has developed.

Landis recently has said he’s “shopping” for a new hip. And he has several choices when it comes to hip replacement hardware, including the standard stainless steel ball/plastic cup. Other options include a ceramic ball/plastic cup, as well as all-ceramic or all-steel replacements.

Because of his activity level, whatever he chooses could last anywhere from three to 25 years, the surgeons said.

Both Westphal and Rothacker said they would do the minimally invasive type of hip replacement surgery on Landis.

“The hardest part would be that this man is so well-muscled that you would have to be getting into his hip joint and pulling all his well-developed muscles out of the way,” Rothacker said.

After the surgery, which generally lasts about two hours, Landis likely will stay in the hospital two to three days. He will get on his feet the day after surgery, using crutches at first, and could be walking on his own two to six weeks later.

He could get on an exercise bike as quickly as two weeks and be out on the road on a bike within four to six weeks, they said.

Perezous said Landis will have to work hard to get ready for next year’s Tour, something he’s shown an incredible willingness to do this year.

And working without the pain that has been his constant companion will make life that much easier for him.

“He’s shown phenomenal grit this year,” Westphal said. “He will come back and, barring some unforeseen circumstance, he could come back and win.”

Said Rothacker: “He’s not the average person. He is an elite athlete and they can do things the average person can’t do.”