Richard Cunningham, MD is a Board Certified Orthopedic Surgeon and Sports Medicine Specialist who is based in Vail, Colorado. He is committed to providing optimal, innovative treatments for patients with knee injuries. He sees and treats a large number of patients with anterior cruciate ligament (ACL) injuries every year. In addition to ACL reconstruction surgery, he does a high volume of ACL repair surgeries where the injured ACL is preserved and repaired.
Innovation in the surgical treatment of ACL injuries is evolving with exciting new options for patients. One of the newest and more exciting advancements in ACL treatment is the Bridge-Enhanced ACL Restoration® (BEAR®) technique. This surgical innovation offers an alternative to traditional ACL reconstruction (ACLR), as previously unrepairable tears can now be repaired.
Dr. Cunningham states, “I am expanding my indications for ACL repair by utilizing BEAR® Restoration technology. This procedure utilizes a bovine collagen implant that is inserted into the ACL repair site. This advanced technology can make it possible to repair tears that were not previously repairable.”
Why The BEAR® Implant Technique?
ACL tears are a devastating injury. They usually affect young, athletic people who participate in cutting and pivoting sports. An ACL tear is usually the result of a non-contact injury. Patients often report stopping suddenly or abruptly changing direction while playing sports as the cause of their ACL injury. These injuries are commonly seen in skiing, soccer, football, and basketball.
The anatomy of the ACL is such that it has limited blood supply and thus limited healing potential. This ligament is located in the center of the knee joint where it is bathed in synovial fluid. This fluid filled environment does not allow for the migration and organization of healing cells to help heal a damaged ACL. Traditionally, torn ACL’s are surgically treated by removing the torn remnants of the ACL and then anchoring a piece of tendon (taken from the patient or a cadaver) back to the femur and tibia bones. Over the last 5 years, Dr. Cunningham has been a pioneer in ACL repair. He has been able to save and repair some torn ACL’s when the ligament tears up high near where the ACL attaches to the femur bone. During ACL repair, small suture anchors are placed in the femur bone and then the sutures coming off of these anchors are woven into the torn ACL thus repairing it back to the femur. However, most ACL tears occur in the middle of the ligament and until now, these were not repairable.
The Federal Drug Administration (FDA) recently approved the Bridge-Enhanced ACL Restoration® (BEAR) technique. This could be a game changer, as it could make tears in the middle of the ACL repairable. Dr. Cunningham is utilizing the BEAR® procedure to repair ACL tears that were previously only able to be treated with a full ACL reconstruction and not repair.
Take a Closer Look at BEAR
In the BEAR® technique, a bovine collagen implant is soaked in some of the patient’s blood and then sutured in the gap left between the ends of the torn ACL. This bovine collagen implant provides a latticework that allows for healing cells from the patient to adhere to it and then ultimately form a ligament bridge between the ends of the injured ACL. Over the course of eight weeks the BEAR implant is naturally replaced by new ligament tissue thus bridging the injured ACL back together.
Benefits of the BEAR® Implant Technique
The BEAR technique provides several advantages over ACL reconstruction surgery, including:
- Preserving one’s own ACL instead of removing it and replacing it with a tendon graft.
- Eliminate the need to harvest a tendon from the patient to be used in place of the torn ACL, thus saving the patient from the pain and swelling associated with this procedure.
- ACL repair is a less invasive surgery with lower surgical risk and a much faster recovery.
This exciting innovation is now available to patients with certain types of ACL tears and Dr. Cunningham is offering it to eligible patients. For more information about the BEAR® Implant procedure, contact Dr. Cunningham at his orthopedic office today: (970) 569-3240.
Special Note: ACL Injury in Young Patients
Incidence of ACL injury in children – Youth and adolescent athletes are at risk for ACL injury. The increase in children participating in sports and playing sports year round is a contributing factor to the increase in ACL tear rates. Orthopedic surgeons working with pediatric and adolescent patients have seen a steady increase in ACL tears in children ages 6 to 18, with a particular uptick among female patients. Although risk prevention programs provide a degree of protection, injuries can occur.
ACL reconstruction surgery in young patients who are still growing requires special considerations to avoid injury to the growth plates. Drilling across active growth plates during ACL reconstruction surgery can cause premature growth plate arrest or angular growth deformities. Risks to growth plates is minimized with ACL repair surgery using the BEAR® implant as there is no need to create bone sockets to accept an ACL graft. This surgery provides a much safer alternative in children with certain types of ACL tears.
Benefits of BEAR® Implant Surgery in Children
Dr. Cunningham treats both elite and recreational young athletes. He has performed ACL repair surgery on a large number of young athletes over the years, thus preserving and allowing one’s injured ACL to heal without removing it and reconstructing it. Now, with the availability of the BEAR® Implant, even more young athletes with ACL tears are candidates for ACL repair. The minimally invasive BEAR® treatment provides young patients who have sustained ACL injuries with the ability to achieve a stable knee once again and to then be able to resume cutting and pivoting sports without the increased risks to their growth plates inherent in ACL reconstruction surgery.
For more information on Dr. Cunningham’s work with the Bridge Enhanced ACL Restoration® (BEAR) surgical technique, contact his Vail, CO office at (970) 476-2451, his Frisco, CO office at (970) 668-3633, or his Edwards, CO office at (970) 569-3240.