Abstract
Objectives:
Anterior cruciate ligament (ACL) tears are prevalent among athletes, often considered a career-ending injury. Evolving management strategies seek to optimize outcomes while minimizing risks associated with repair and reconstruction. Bridge-enhanced ACL repair (BEAR) offers a novel approach using a scaffold implant to bridge and fuse torn ACL ends, aiming to restore the ligament’s original structure and function.
Methods:
This review article focuses on evaluating BEAR as a novel approach for ACL tear management. PubMed and Google Scholar were searched using keywords “bridge-enhanced ACL repair,” “ACL repair,” and “BEAR in ACL repair” from 2010 to 2023.
Results:
ACL reconstruction is generally considered a successful, necessary, and low-risk procedure. However, the adverse consequences of ACL reconstruction can extend beyond a “successful” reconstruction. BEAR aims to address these issues by utilizing an absorbable protein-based implant attached to the torn ACL tip, aiding healing as the body absorbs the implant. Promising outcomes from BEAR applications suggest its efficacy in treating ACL tears, potentially preserving nerve fibers crucial for knee function, especially in younger patients. However, limitations include a limited focus on mid-substance tears, lack of research on tears with more than 50% of the ACL length lost, studies on BEAR being limited to early repair (< 3 months), and the unavailability of long-term studies. The current condition in Indonesia mainly involves chronic cases, which limits the use of BEAR for ACL treatment. It is also often aggravated by patient’s lack of knowledge regarding the nature of its severity.
Conclusion:
BEAR shows promise as an effective treatment for ACL tears, offering positive results in several studies. Addressing current study and practical limitations will further enhance its potential to challenge the established future gold standard in ACL injury management.