BEAR Surgery for ACL Tears: Options and Recovery Insights

Anterior cruciate ligament (ACL) tear BEAR (Bridge-Enhanced ACL Repair) ligament reconstruction surgery?

Last week, after undergoing an MRI at the hospital, the doctor informed me that I have a complete tear of the anterior cruciate ligament (ACL).
It likely occurred about two weeks ago.
I've been researching articles regarding autograft and synthetic ligament reconstruction, and I've noticed a few points.

For autografts using the hamstring tendon: it requires an additional incision, has a longer recovery time, and muscle strength takes a long time to regain.
On the other hand, many articles I found about synthetic ligaments are somewhat outdated.
They indicate a faster recovery speed, but there is a risk of rupture or loosening after a certain period.
However, recent advancements in synthetic fiber ligaments suggest that ligament tissue can grow over them, potentially reorganizing into a functional ligament that does not tear.
(There is limited data on this.)
Since I hope to return to normal life, school, and sports competitions as soon as possible, I'm uncertain about which option to choose.
Initially, I considered a synthetic ligament, but I am concerned about the possibility of it tearing later.
I later learned about the BEAR (Bridge-Enhanced ACL Repair) procedure, which seems to have promising results.
This technique involves suturing the torn ACL together and using a special implant, along with injecting a solution containing my own platelets for repair.
Clinical trial results indicate that muscle strength recovers faster than with traditional ligament reconstruction, and the ligament heals into a complete structure.
However, I haven't found any Chinese-language patient experiences related to this surgery.
I wonder if this procedure is available in Taiwan (I currently reside in Keelung).
If it is, would you recommend this surgery? If not, would you recommend an autograft or the latest synthetic ligament for reconstruction?

Xiao Xuan, 20~29 year old female. Ask Date: 2017/12/10

Dr. Chen Yongxue reply Orthopedics

Currently, the mainstay for anterior cruciate ligament reconstruction is still autograft transplantation.
There are concerns regarding the lifespan of synthetic ligaments.
Additionally, the results of the BEAR technique have not yet been widely accepted by the orthopedic community.
Therefore, it is advisable to consider autograft reconstruction.
Thank you.

Reply Date: 2017/12/10

More Info

The BEAR (Bridge-Enhanced ACL Repair) surgery is an innovative approach to treating anterior cruciate ligament (ACL) tears that has garnered attention for its potential benefits in recovery and rehabilitation. This technique involves suturing the torn ends of the ACL together and using a special implant that is infused with the patient’s own platelet-rich plasma (PRP) to promote healing. The idea is that this method can lead to faster recovery times and a more natural restoration of the ligament compared to traditional reconstruction methods.

In Taiwan, the landscape for ACL surgeries, including BEAR, is evolving. While traditional methods such as autograft (using the patient’s own tissue) and allograft (using donor tissue) remain the gold standard, there is increasing interest in newer techniques like BEAR. However, the availability of BEAR surgery may vary by medical center. It is essential to consult with specialized sports medicine departments in major hospitals, as they are more likely to be up-to-date with the latest surgical techniques and research.

When considering your options, it is crucial to weigh the pros and cons of each method. Autograft procedures, which often use hamstring tendons or the patellar tendon, are widely practiced and have a long track record of success. However, they do involve additional surgical sites and longer recovery times due to the need for the body to heal the donor site. On the other hand, allografts can provide quicker recovery but may carry risks such as graft rejection or disease transmission.

The BEAR technique, while promising, is still relatively new, and its long-term outcomes are not as well-established as those of traditional methods. Clinical trials have shown encouraging results, indicating that patients may experience quicker strength recovery and a more natural healing process. However, it is essential to note that the orthopedic community has not universally accepted BEAR yet, and more extensive studies are needed to confirm its efficacy and safety.

If you are considering BEAR surgery, it is advisable to consult with an orthopedic surgeon who specializes in sports medicine. They can provide insights into whether this procedure is available in your area and whether it is suitable for your specific case. Additionally, they can discuss the potential risks and benefits compared to traditional ACL reconstruction methods.

In summary, while BEAR surgery presents an exciting option for ACL repair, it is essential to have a thorough discussion with your healthcare provider about the best approach for your situation. Factors such as your activity level, the extent of your injury, and your personal recovery goals should all be considered in making an informed decision. If BEAR is not available, both autograft and allograft options remain viable and effective choices for ACL reconstruction.

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