February 25, 2022
Breakthrough Technology Can Help Heal ACL Injuries
Approximately 400,000 ACL injuries occur in the United States each year. Historically, orthopedic surgeons have had limited options in treating a torn ACL. With ACL reconstruction using today’s standard of care, the surgeon completely removes the remaining damaged ACL and reconstructs it with either a tendon from the patient’s own leg (called an autograft) or a deceased donor (called an allograft).
At Cedars-Sinai Kerlan-Jobe Institute, we are pleased to now offer a new technology in ACL reconstruction called the BEAR® Implant. The implant is the first medical advancement granted approval from the U.S. Food and Drug Administration (FDA) that enables the body to heal its own torn ACL. This new approach is a paradigm shift from traditional ACL reconstruction and is the first innovation in ACL tear treatment in more than 30 years. I am proud to have recently become the first orthopedic surgeon in Southern California to perform this innovative procedure and excited about its potential for both younger and older patients.
ACL injuries can vary based on their severity and are graded by the diagnosing physician. A grade 1 injury indicates the ACL has sustained minor damage and over-stretching but has retained the ability to keep the knee joint stable. A grade 2 ACL tear means then ACL has become stretched and loose and is often referred to as a “partial tear.” Grade 3 ACL tears are the most severe and are referred to as a “complete tear,” where the ACL has torn into two pieces, thereby rendering the knee unstable. Because a completely torn ACL does not heal on its own without treatment, ACL reconstruction surgery is one of the most common orthopedic procedures in America. Yet the procedure can have drawbacks, especially depending on the training and experience of the surgeon, as well as the tactics he or she employs to perform the ACL reconstruction surgery.
Unlike traditional ACL reconstruction, the BEAR Implant does not require a second surgical wound site to remove a healthy tendon from another part of the leg or the use of a donor tendon. The BEAR Implant acts as a bridge to help ends of the torn ACL heal together. Through a minimally invasive procedure, the surgeon injects a small amount of the patient’s own blood into the implant and inserts it between the torn ends of the ACL. The combination of the BEAR Implant and the patient’s own 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, within approximately eight weeks.
Preserving a patient’s native ACL instead of replacing it with a graft has long been a goal of orthopedic surgeons, as there are numerous advantages to restoring a ligament instead of replacing it. First, both traditional ACL reconstruction approaches (autograft and allograft) have an ACL re-tear rate as high as 20% for teens and as high as 9% for adults. Additionally, following ACL reconstruction, many athletes are unable to return to the same level of sport they engaged in before the ACL injury occurred.
As with any surgery, ACL reconstruction has certain risks. Depending on the type of graft used, there can also be clinical complications. About half of the people who receive patellar tendon grafts experience pain while kneeling, and those who receive hamstring grafts have persistent knee weakness – as much as a 50% deficit at two years. In addition, if the ACL is re-injured, revisions with the BEAR Implant are easier. Revisions to traditional ACL reconstruction can be complicated and can require multiple surgeries.
Clinical studies have demonstrated that the BEAR Implant restores torn ACL quality and size similar to a patient’s non-injured ACL. Compared with autograft ACL reconstruction, the implant has also shown faster recovery of muscle strength and higher patient satisfaction regarding return-to-sport readiness.
Patients should discuss their individual symptoms, diagnosis, and treatment options with their surgeon. The BEAR Implant has the same potential medical/surgical complications as other orthopedic surgical procedures, including those involved with ACL reconstruction. These include the risk of re-tear, infection, knee pain, meniscus injury and limited range of motion in the affected knee.
The BEAR Implant may not be right for all patients in all ACL tear cases. If you are at least 14 years of age, have a complete rupture of the ACL (as confirmed by MRI) and can undergo the surgery within 50 days of the injury, you might be a good candidate for the BEAR Implant. Call us at (310) 829-2663 to learn more.
(BEAR IMPLANT Communications Toolkit)