Can Landis Pull a Lance Comeback?

Tour de France winner Floyd Landis will soon exchange his champion's yellow jersey for a hospital gown.

Landis just won the intensely difficult cycling race, despite suffering immense pain from his injured hip. He postponed surgery until after the race.

But will Landis wear the yellow jersey again? It's unknown at the moment. The cyclist has osteonecrosis in his right hip, also called avascular necrosis, in which the ball of the hip joint has lost its blood supply, causing the bone to wear down. It was brought about by a previous cycling crash.

"When the blood supply is compromised, the bone will die," said Dr. Michael Dayton, an orthopedist at the University of Colorado Health Sciences Center.

Did racing in the Tour make Landis' hip worse? Dayton said no.

"I don't think he was doing more damage to the bone," he said. "He was just suffering the pain."

The surgery will replace his hip with a titanium or cobalt chromium implant. Since Landis is in great cardiovascular health with strong muscles around his hip joint, he is expected to have a good surgical outcome.

"Given his conditioning, his prospect for recovery is very good, and more than likely he will race again," Dayton said.

After the surgery, Landis should no longer suffer the daily pain of osteonecrosis.

"His chances of recovery to lead a normal life in relatively painless fashion are excellent," said Dr. David Markel, an orthopedic surgeon at Providence Hospital in Michigan.

However, the implants do falter, especially in an active athlete.

"He is more prone to having his hip fail faster than someone who is not doing competitive cycling," Dayton said.

The implant can become loose, causing pain. Also, the immune system can attack the tiny particles that break off the implant after wear and tear.

Many experts compared Landis' situation to that of famed athlete Bo Jackson.

The professional baseball and football player injured his hip in 1991 playing for the Oakland Raiders. The resulting condition was the same avascular necrosis that Landis suffered after a 2003 bicycle crash. Jackson had surgery in 1992, then returned to baseball, playing for the Chicago White Sox and the L.A. Angels. He retired in 1995.

"Bo Jackson was forced to have multiple revision procedures because he remained active, playing baseball after his surgery," said Dr. Mark Miller, head of sports medicine at the University of Virginia. "Although cycling is certainly lower impact than baseball, Landis will have an increased risk of early failure if he is too active."

Experts agreed that Landis will ride again but are unsure if he can get up to speed to win another Tour de France. "I think if he could race with the avascular necrosis he will likely be able to race with the total hip [replacement]," Markel said.

Miller worries about the bigger, postrace picture.

"Based on his performance in the Tour de France, I think he could ride competitively. I just don't think it is the wisest decision from a long-term quality of life perspective," Miller said.

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