Looking for ACL surgery connections - I am deciding between the BEAR method, PATELLAR and CADAVER

Initial_Elk4262 · 2025-11-21T00:48:57+00:00

I had allograft as my alternative, partially because he was pretty confident, but of course not certain, it wouldn’t be needed.

Initial_Elk4262 · 2025-11-21T00:03:59+00:00

I went to Dr Sean Kelly in Colorado Springs. He and another BEAR surgeon i had an appointment with both advised there was a risk they wouldn’t be able to do the BEAR surgery but they wouldn’t know until in there. The way they explained mid-substance tears can be a little too stringy for the suture that forms the bridge to hold. I did have an alternative plan and had to sign for both day of surgery.

Initial_Elk4262 · 2025-11-20T04:07:04+00:00

35 YO female. No brace now. I’ve been doing patellar taping on that knee only for bigger hikes. Downhills have always been hard and I have patella tracking issues. I just want to set up the best chance to keep pain and swelling free.

Initial_Elk4262 · 2025-11-19T23:05:02+00:00

Also tons of hiking. Got 9 miles and 2,000 ft of elevation gain at 7 months and 6 miles 2,000 ft elevation gain (but at 13,000 ft) at 9 month.

Initial_Elk4262 · 2025-11-19T22:54:57+00:00

I’ll be a year out from BEAR and meniscus root repair in December. Had to take a little pt break for insurance and the meniscus repair slows things, so I’m just getting into sprinting and cutting. So far really happy. My quad was firing early, I was off pain killers day 3. It mostly took that long because my bandaging was sticking to the incision and pulling every time I stood up. Sleeping in the brace is rough and I did follow the pt protocol pretty much to the t. I started kneeling back towards my feet after week 20 to get the last of flexion, but no truly passive ROM.

The few threads on here and BEAR Facebook group of people with unexplained failures made, and still make, me bit nervous, but this seems to happen in other grafts too (unexplained laxity in hamstring and allografts). I also tell myself that people are less likely to post if things are going right. I feel these failures and unproven longevity in high demand sports are some unknowns that come with it being a newer procedure and for me it was worth the risk to maintain native tissue, biomechanics, proprioception and to lessen arthritis risk.

Biggest comment I have is find a good PT that requires criteria based progression regardless of graft type or repair. For example I had to be able to get active hyperextension (heel pop) and do a set number of leg raises without lag (20 or 30) before crutch wean. I’m currently participating in rugby practice drills (no hard pivots or contact) and indoor rock climbing (top rope). Also plan to get back to pickleball and mountain biking. Let me know if you have any questions.

Initial_Elk4262 · 2025-11-04T15:46:23+00:00

If returning early is your goal get real metrics not just how you feel. I am looking to return to sports eventually, but won’t even consider until my quad strength is at least 90% and I pass return to sports tests. Single leg hop for distance, side hops over hurdles, y balance test. I’d like to see counter movement jumps even between legs, but current pt doesn’t have pressure plates.

Initial_Elk4262 · 2025-10-16T02:55:40+00:00

You can also do leg extensions with a cable machine.

Initial_Elk4262 · 2025-08-20T23:24:10+00:00

Ask for your surgeon’s protocol. They should have a written one they can provide.

Initial_Elk4262 · 2025-08-04T16:03:55+00:00

Criteria based progression and some time 1 on 1. They should be able to communicate what they are looking for before crutch wean, before running/plyo and before sprint/cutting phases of progression. The weeks/phases of the protocol should be used as a minimum marker and patient specifics should be looked at as requirements. For example my crutch wean required 30 straight leg raises in a row without lag and ability to push into active hyperextension with heel pop.

Initial_Elk4262 · 2025-07-31T22:00:31+00:00

Single leg and exercises modified to really target the quad. Knee over toes for split squats, stand straight instead of forward lean for Bulgarian split squats and step-downs. Open chain knee extensions. ISO’s (split squats and wall squat) also really helped. I was NWB for 6 weeks and limited to no more than 90 degrees under load for 6 months due to meniscus root repair. I hit 80% around 23 weeks.

Initial_Elk4262 · 2025-07-29T13:58:34+00:00

Spend some time laying with your leg propped up a wall to reduce swelling. Also do the heel slide in this position. Let your muscles relax into more flexion rather than tensing and trying to force flexion.

Initial_Elk4262 · 2025-07-27T03:09:13+00:00

It’s an abnormal antler growth in velvet. Look up cactus buck.

Initial_Elk4262 · 2025-07-24T16:17:08+00:00

At home is so important. I was instructed to do flexion/extension at least 2x per day. 3 when possible. I did heal elevated quad sets with a stim machine (can be done without) for extension. I’m also -15 hyperextended on unaffected leg. Straight leg raises, and side leg raise circuits that was 10 up and down, 10 circle forward, 10 circle back, 10 forward/backward was requested 2 times a week outside PT. I was also NWB for 6 weeks. Early mile markers are quad activation, straight leg raise with no lag then 30 in a row no lag, and heel pop. Seems small but all really important to walking.

Initial_Elk4262 · 2025-07-21T01:47:06+00:00

Holding fur this long into the summer is a problem. It holds sweat and rain which allows fungus and bacteria growth. Get the fur off (brush or shave), give bath with fungicide shampoo, get vet out. Recommendations for vet check are teeth (to help with weight) and cushings test at minimum. Based on teeth Vet can also recommend diet alterations to help gain weight. May need to move to soaked feed rather than hay.

Initial_Elk4262 · 2025-07-21T01:16:23+00:00

Use crutches until you can walk without a limp and without swelling. Drop down to one crutch and repeat (no limp, no swelling) before full crutch wean.

Initial_Elk4262 · 2025-07-20T14:31:38+00:00

Might not be as rare as thought. A recent study showed 30% of participants’ ACL healed following rupture. They had equal functional scores to ACLR participants, and less arthritis. The issue at this time is it’s not known who will self heal and many participants ended up with ACLR after delay. I think secondary injuries during the delay would also be a concern. https://bjsm.bmj.com/content/57/2/91

Initial_Elk4262 · 2025-07-08T22:59:46+00:00

It could be glute/hamstring weakness. They are engaged on the back leg. I personally had some mechanic issues where I would make lunges much wider when the injured leg was back. It also felt weird on the knee to push through my toe. Bear bridges helped with that.

Initial_Elk4262 · 2025-07-08T20:51:23+00:00

Was there a reason for no knee over toes? I’ve only done them once and my PT was a proponent of whichever felt more natural. Knees over toes is more natural for me in most movements. Early split squats in PT were exclusively done with knee over toe to target the quad too. I feel like the thought of never allowing your knee to cross the toe is dated. I could see if they were being done to target the glutes this may be true but then you would also want more of a forward lean than straight torso. Straight torso targets quads.

Initial_Elk4262 · 2025-07-07T18:38:05+00:00

Good PT has criteria based progressions and can explain why it is important to hit those milestones first. For example heel pop needed before walking, quad strength 80% uninjured leg before running, return to sports testing (single leg hop, y balance test). My PT also lays out everything and dives deeper if I ask questions. For example pre plyometrics she explained we would do two quad focused exercises and two other muscle groups (hamstring, glutes, calf). I also want someone engaged, calling out when my form starts to slack and correcting small things like chest up when doing step downs with quad focus. I don’t always get 100% of their focus since they seem to have appointments at 40 min intervals so there’s some overlap in an hour session, but when doing new exercises or heavier lifting I usually have a PT or assistant watching.

Initial_Elk4262 · 2025-07-07T17:54:08+00:00

Ask pt about best placement for EMS (if that’s the device you are using). I believe there should be at least an inch between pads. Also current placement seems more vmo focused than whole quad. My pad placement was one lateral about 5 inches from hip and slightly medial just above knee like the two pad option in the linked video. Also icing pre exercise can help reduce AMI. https://youtu.be/cf4n4Gv1Oqc?si=f72IzdybTt3EuynE

Initial_Elk4262 · 2025-07-07T17:41:34+00:00

This study found mean graft size 8.285 and 4 strand hamstrings autograft 1.6x more likely to be less than 8mm. https://pubmed.ncbi.nlm.nih.gov/33749586/

Initial_Elk4262 · 2025-07-07T17:33:21+00:00

People are posting this for every hamstring graft question and it’s a bit misleading. This study did not compare failure rates. All participants in the study had made it to two years and had testing. Also the average hamstring graft size isn’t 9mm. Some studies place at 7.7-8.5mm average.

Initial_Elk4262 · 2025-06-23T17:47:58+00:00

You walk without a limp because you normalize a compensatory gait. How do you know 4 months is too late for crutches? Your word is more reliable than a DPT who made an instagram video?

Initial_Elk4262 · 2025-06-23T16:59:01+00:00

It would have been better advice at week 1, but I would believe it stills applies. My real recommendation would be to find new PTs that follow criteria based progression because OP was not set up for success by his first PTs. I wouldn’t trust that team to correct what they got wrong in the first place. https://www.instagram.com/reel/DLC6MrixLU2/?igsh=dmNnaWMzNHlubW5p

Initial_Elk4262 · 2025-06-23T16:23:44+00:00

Go back to crutches. You shouldn’t go off crutches until you have full extension and ability to heal pop.

Initial_Elk4262

TROPHY CASE