Table 2.
Advantages and Disadvantages of BEAR-Augmented ACL Repair Compared With Autograft ACLR
| BEAR-Augmented ACL Repair | Autograft ACLR | |
|---|---|---|
| ACL size and orientation | Restores native ACL cross-sectional area and orientation23 | Graft remains nearly 50% larger than contralateral ACL at 2 yr postoperatively23 |
| Donor-site morbidity | No graft donor-site morbidity | Potential for anterior knee pain, reduced quadriceps or hamstring strength, loss of range of motion, donor-site skin sensitivity, and inability to kneel depending on autograft and harvesting technique used24 |
| Hamstring strength | Increased hamstring strength at 2 yr compared with hamstring autograft ACLR18 | Weaker hamstring strength at 2 yr18 |
| Anterior knee pain | Less anterior knee pain compared with BTB autograft ACLR | Anterior knee pain experienced by 22%-23% of patients undergoing ACLR with BTB autograft25,26 |
| Postoperative recovery | Earlier postoperative resolution of symptoms and return to function18 | Lower patient-reported outcomes at early postoperative time points18 |
| Return to sport | Greater return-to-sport readiness at 6 mo19 | Lower return-to-sport readiness at 6 mo19 |
| Knee proprioception | Preserves native knee kinematics and proprioception6,20,21 | Removes proprioceptive fibers of native ACL and alters knee kinematics and kinetics27,28 |
| Tibial insertion | Preserves native ACL tibial insertion | Alters native ACL tibial insertion |
| Anterior-posterior knee laxity | No statistically significant difference29 | No statistically significant difference29 |
| Revision rate | No statistically significant difference17,22,30, 31, 32 | No statistically significant difference17,22,30, 31, 32 |
ACL, anterior cruciate ligament; ACLR, anterior cruciate ligament reconstruction; BEAR, bridge-enhanced anterior cruciate ligament restoration; BTB, bone-patellar tendon-bone.