By Duke Medicine News and Communications

DURHAM, N.C. -- Floyd Landis, who just won the 2006 Tour de France, has a good chance of continuing his career as a competitive bicyclist after upcoming surgery to repair a degenerative hip, according to James Urbaniak, M.D., orthopedic surgeon at Duke University Medical Center.

Landis, 30, suffers from a condition known as avascular necrosis, which causes the bone that forms the "ball" of the hip joint to die and crumble. Landis developed the condition after a cycling accident.

"I would say that the likelihood of him successfully competing again would be very good after surgery," said Urbaniak, Virginia Flowers Baker Professor of Orthopedic Surgery at Duke. "Cycling, like swimming, is not an impact sport and is one of the few sports in which someone with a hip replacement could compete at that level. The new hip could also actually improve his ability to compete."

The only drawback to total hip replacements is that the more active the recipient, the sooner the joint needs to be replaced, Urbaniak said.

Artificial hips have an average lifespan of about 15 years, which means that young patients would likely need multiple joint replacements during the course of their lives. So Urbaniak developed a procedure designed specifically for young, active patients with avascular necrosis.

First performed in 1979, the procedure, known as a free vascularized fibular graft (FVFG), uses the patient's own tissue to reconstruct a new joint. In the surgery, Urbaniak inserts a portion of the fibula leg bone with its accompanying blood supply into the dying ball. Over a period of time, a new joint forms.

"If we catch the avascular necrosis soon enough, the FVFG procedure works in more than 80 percent of cases," Urbaniak said. He has performed more than 2,500 of the procedures on patients from around the world.