Tearing an anterior cruciate ligament (ACL) — the flexible band inside the knee that helps stabilize it — can upend a sports career and sideline weekend athletes. Between 100,000 and 200,000 ACL tears occur each year in the United States.
The most effective repair option has been removing the ruptured ACL, harvesting a graft from the shin or elsewhere, sewing that tissue into the knee, and hoping both surgical sites heal well.
In December 2020, the FDA approved a simpler, more natural method: the Bridge-Enhanced ACL Restoration (BEAR).
“We basically stimulate the ACL to heal itself,” says Martha Murray, MD, orthopedic surgeon-in-chief at Boston Children’s Hospital and BEAR’s creator.
The approach involves placing a protein-based sponge, prepared with some of the patient’s own blood, between the torn ACL ends. Murray explains that the blood promotes the connection of the two ACL pieces to the sponge and, ultimately, to each other.
So far, the approach has been tested on more than 100 patients. In a May 2020 study, patients and physicians reported that BEAR performed as well as the standard repair — and without the graft surgery that can cause ongoing pain or weakness at the donor site. Miach Orthopaedics, which has the worldwide exclusive license for the BEAR implant, has already begun making it available through orthopedic surgeons in the United States.
For Murray, the experience has highlighted the value of serving as a physician-researcher. “When you’re faced with a patient with a problem and the current solution is imperfect, it’s great to be able to say, ‘We’re working on a better solution.’ It’s incredibly gratifying.”
