Did you know that ACL surgery hasn’t had a true innovation for over 30 years? I was excited to learn more about the BEAR® Implant for treatment of anterior cruciate ligament (ACL) tears, one of the most common knee injuries in the U.S. It is the first FDA-approved medical technology to enable healing of a torn ACL. This new approach is a shift from the current standard of care, reconstruction, which replaces the ACL with a graft. I talk to our local news station, KGW, about it here
The ACL reconstruction is the most common orthopaedic procedures in the U.S., with approximately 400,000 ACL injuries occurring annually. A torn ACL does not heal without treatment and this is why we usually reconstruct the ACL with tissue we obtain from elsewhere. This is often tissue from the patient, or from a cadaver.
While the reconstruction of the ACL is a tried and true surgery, with good outcomes, there are a number of advantages to restoring a ligament instead of replacing it, and this exciting medical technology is the first to enable the body to heal its own torn ACL while maintaining the natural knee anatomy.
What does the procedure entail?
Unlike reconstruction, the BEAR Implant does not require removing healthy tendon from another part of the leg or using a deceased donor’s tendon. Instead, the implant acts as a bridge to help ends of the torn ACL heal together.
When I perform the bridge-enhanced ACL repair, I inject a small amount of the patient’s own blood into the collagen implant and insert it between the torn ends of the ACL in a minimally invasive procedure. The combination of the collagen implant and the patient’s blood enables the body to heal the torn ends of the ACL back together while maintaining the ACL’s original attachments to the femur and tibia. As the ACL heals, the BEAR Implant is resorbed by the body, usually within eight weeks.
Who is the procedure for?
You may be a candidate for the BEAR Implant if you are at least 14 years of age, skeletally mature, with a complete rupture of the ACL, as confirmed by MRI. You must have enough of your own ACL still attached to the tibia to facilitate the restoration. Also, the BEAR device must be implanted within 50 days of injury. Outside of 50 days, you may still be a candidate for a traditional ACL reconstruction.
What are the benefits?
Additionally, traditional ACL reconstruction approaches can have an ACL re-tear rate as high as 20% for teens and as high as 9% for adults. If the ACL is re-injured, revisions to traditional ACL reconstruction can be complicated and can require multiple surgeries, whereas revisions with the BEAR Implant are easier and more predictable.
The BEAR Implant has the same potential medical/surgical complications as other orthopedic surgical procedures, including ACL reconstruction. These include the risk of re-tear, infection, knee pain, meniscus injury and limited range of motion. You should discuss your individual symptoms, diagnosis and treatment with your surgeon.
