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. 2020 Jul 1;8(7):2325967120927655. doi: 10.1177/2325967120927655

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© The Author(s) 2020

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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Figure 1. — Stepwise demonstration of the bridge-enhanced anterior cruciate ligament (ACL) repair technique using the bridge-enhanced ACL repair (BEAR) implant. (A) In this technique, the torn ACL tissue is preserved. A whipstitch of No. 2 Vicryl (purple suture) is placed into the tibial stump of the ACL. Small tunnels (4 mm) are drilled in the femur and tibia, and an Endobutton with two No. 2 Ethibond sutures (green sutures) and the No. 2 Vicryl ACL sutures attached to it is passed through the femoral tunnel and engaged on the lateral femoral cortex. The Ethibond sutures are threaded through the implant and tibial tunnel and secured in place with an extracortical button. (B) The implant is then saturated with 5 mL of the patient’s blood, and (C) the tibial stump is pulled up into the saturated implant. (D) The ends of the torn ACL then grow into the implant, and the ligament reunites. (Reprinted with permission from Murray MM, Flutie BM, Kalish LA, et al. The bridge-enhanced anterior cruciate ligament repair (BEAR) procedure: an early feasibility cohort study. Orthop J Sports Med. 2016;4(11):2325967116672176. SAGE Publishing.)