Preserve Your Knee with Bridge-Enhanced ACL Repair (BEAR)
Board-certified orthopedic surgeons at ROC perform ACL reconstruction as a way of returning to a patient’s previous activity level. Every year, approximately 400,000 ACL injuries occur in the U.S. A torn ACL does not heal properly without treatment, making ACL reconstruction one of the most common orthopedic procedures in the country.
Recent advancements are reshaping orthopedics’ approach to ACL surgery, making repair of the ACL (rather than reconstruction) a viable option, and offering patients an alternative that focuses on preserving the body’s native tissues rather than replacing the ACL with a tendon.
ROC’s Dr. Jeffrey Feinblatt is trained to perform ACL repair using the BEAR® (Bridge-Enhanced ACL Repair) implant to help his patients return to all activities. Dr. Feinblatt has been performing ACL repair with BEAR ACL repair with BEAR for 2 years and is considered one of the most experienced surgeons in the Pacific Northwest with this procedure.
Why The BEAR Implant?
The BEAR implant is the first major innovation in ACL treatment in more than 30 years. It is the first FDA-approved medical technology to enable healing of a torn ACL. This is a paradigm shift from current reconstruction where the native ACL is cut out and a tendon (from the patient or cadaver) is used to replace/reconstruct the ACL.
Unlike reconstruction (cut out and replace), ACL repair with the BEAR implant does not require a second surgical wound to harvest a healthy tendon from the patient or use a deceased donor’s tendon. Instead, the BEAR implant acts as a bridge to help ends of the torn ACL heal together.
Answers to ACL Treatment Questions
What are some drawbacks to ACL reconstruction?
-Roughly half of the patients who receive patellar tendon grafts experience pain while kneeling.
-Those who receive hamstring grafts have persistent weakness. As much as a 50% deficit at two years.
-ACL reconstruction has a re-tear rate as high as 20% for teens and as high as 9% for adults.
-Revision ACL procedures can be fraught with technical difficulties.
Why is ACL repair an option now when it wasn't previously?
The ACL wants to, but does not, heal well on its own. Synovial fluid, a thick liquid present in the joint, nourishes and improves motion between the cartilage cap at the ends of the bones, but also prevents the formation of a blood clot around the torn ends of the ACL that is vital to healing.
Until now, orthopedic surgeons did not have a good way to establish and maintain this blood clot around the ACL. As such, surgery previously focused on reconstruction – cutting out the remaining ends of the ACL, drilling holes in the femur and tibia with holes that approximate the attachment sites of the ACL and replacing the ACL with a tendon from the patient or a cadaver.
Now, with ACL repair, the ACL attachment sites on the bone are maintained. The ACL is sutured, and the ends are brought together along with the BEAR and the patient’s blood. The implant is placed through a small incision off the side of the kneecap; all other procedures, including meniscal work, are performed arthroscopically. The implant holds and protects the blood, allowing the formation of a clot and facilitating the body’s own natural healing response, including cell migration and proliferation. Over the next 8 weeks, the BEAR implant is resorbed by the body and replaced with native ACL tissue, which continues to remodel and strengthen over time.
Who is the BEAR procedure for?
Dr. Feinblatt may recommend ACL repair with the BEAR implant if you are at least 14 years of age, with a rupture of the ACL, confirmed by MRI. You must have an ACL stump attached to the tibia to facilitate the restoration.
The BEAR implant and ACL repair have some of the same potential medical/surgical complications as other orthopedic surgical procedures. These include the risk of re-tear, infection, knee pain, limited range of motion, deep venous thrombosis, and anesthetic risk.
ROC’s BEAR Implant Surgeons
Jeffrey Feinblatt, M.D.
Reconstructive Knee, Foot, and Ankle Surgery and Sports Medicine
The BEAR implant and ACL repair represent a significant advancement in how we approach ACL procedures. It matches my philosophy, that we should try to repair and restore function whenever feasible. I believe that as the procedure gains more widespread use, the ability to preserve and restore native ACL fibers will become the default procedure when possible, and surgeons will use ACL reconstruction (using a patient’s or cadaver tendon) only in cases where the ACL cannot be repaired.
ROC's Work with BEAR
Dr. Feinblatt at a course for surgeons experienced with ACL repair and the BEAR implant.
Passing suture through the BEAR implant.
ACL repair with BEAR appearance at 4 months. The patient was brought to the OR for stiffness in the knee.
