UAB Sports & Exercise Medicine Performs Alabama’s First Bridge-Enhanced Procedure

By Laura Freeman

Whether you want to get in shape, stay in shape, or just have fun, most people enjoy playing sports a lot more than counting sit-ups. The problem comes when fast, twisting motions and sudden slips pull or turn joints in ways they aren’t built to go.

One of the injuries that can occur is an ACL tear. Anterior cruciate ligaments are strong bands of tissue that connect the femur to the tibia at the knee. When damaged, repair is necessary to restore function.

“In the past, there were only two options: graft other tissue taken from the patient, or graft donor tissue. Either choice came with a risk,” said Amit Momaya, MD, an orthopedic surgeon in the Department of Orthopedic Surgery at UAB. “When a graft is taken from the patient, it can permanently affect stability, strength and balance. If the graft comes from a donor, there is the possibility of rejection and side effects from measures to prevent it.

“The Bridge-Enhanced ACL Restoration, also known as BEAR, uses an implant that will dissolve when no longer needed to hold the tissue edges in place and protect blood flow in the gap while the body uses its own blood to heal itself. A natural clot forms, and within eight weeks, the implant dissolves and is replaced with cells, collagen and blood vessels. The tissue continues to remodel and strengthen over the next few months.”

The FDA has approved use of the sponge-like implant that provides a scaffolding for the torn edges of the ACL to heal together. The implant was pioneered by Martha Murry, MD, founder of Miach Orthopaedics , at the Boston Children’s Hospital department of orthopaedic surgery. Research was funded by the NFL Players Association, Boston Children’s Hospital and the National Institutes of Health. UAB Sports Medicine and Exercise participated in the multicenter randomized controlled trial for the BEAR procedure with Momaya as medical monitor for the past several years.

“This procedure gives patients the option for their original ACL to heal itself, which may help maintain strength in the knee and balance which can be lost when other knee tissue is harvested for a graft and the original ACL is completely removed,” said Momaya, who also serves as Chief of Sports Medicine at UAB. “Maintaining strength and balance are important for professional athletes who are concerned about their careers and for young athletes on high school and college teams who have their lives ahead of them.

“Many of the ACL tears we see happen while playing team sports like football, basketball, soccer, and baseball, but it can also occur in weekend warriors out playing tennis or climbing, or in ordinary work activities involving knees such as jumping from a fire truck or van, as well as in traffic accidents.”

However the injury occurred, the Sports and Exercise Medicine clinic at UAB can evaluate the injury and follow up with the care most likely to deliver the optimum outcome. The time between the tear and full healing for ACL damage can take a while, but the BEAR procedure seems to improve the odds for getting nearer the “back to 100 percent” goal patients hope to reach.

Ideally, the procedure should be performed soon after the injury while edges of the tears can be easily repositioned together. To learn more or schedule a BEAR evaluation for your patient, call (205 930-Bone) or visit UABMedicine.org.