“Am I too old for this?” is one of the most common questions people ask after an ACL tear,
especially if they are no longer a teenager or a college athlete. It is a reasonable thing to
wonder, but age alone does not determine whether the BEAR Implant may be an option.

To understand how age actually fits into the decision, we spoke with orthopedic surgeons
Dr. Dayne Mickelson and Dr. Tyler Nathe of Proliance Surgeons, where about half of their
BEAR Implant patients are age 40 and older.

Below are four things they want patients to know, along with stories from three people in
their 50s and 60s who chose ACL restoration.

1. Eligibility comes down to your knee, not your birthday

Early clinical studies for the BEAR Implant focused on patients ages 14 to 35, which gave
researchers a clear starting point to evaluate safety and outcomes. The U.S. Food and Drug
Administration approved the BEAR Implant in December 2020 for patients age 14 and older,
and in 2025 approved expanded use for children and adolescents as young as age 2.

Patients of all ages can potentially benefit from this restoration option rather than a full
reconstruction,” Dr. Mickelson explains. “We have more and more patients come in asking if
they are a candidate.”

When a surgeon evaluates you, they are not checking your age against a cutoff. They are
looking at the type and pattern of your tear, how much ligament is still intact, how recently
the injury happened, and the overall condition of your knee.

“The treatment options for ACL injuries revolve around a number of important factors” Dr.
Mickelson says. “It really depends on the type of ACL tear and the condition of the ACL
remnant. It must have a good appearance on the MRI and intraoperatively.”

Real-world use reflects that. Since FDA approval, 34% of BEAR Implant procedures have
been performed in patients age 35 and older. Ongoing research including the Bridge
Registry, BEAR III, and BEAR MOON continues to evaluate outcomes across a wide range of
patients.

“I see it every week in clinic,” Dr. Nathe says. “We treat people based on their activity level
and lifestyle, not their chronological age.”

2. What you want to get back to matters more than how old you are

“Patients in their 60s and even 70s are still skiing, playing tennis, hiking, lifting, chasing
grandkids, and they fully expect to get back to all of it after an ACL injury,” Dr. Nathe notes.
“I recently treated a 67-year-old who tore their ACL skiing in the Swiss Alps. That’s the
conversation now, not ‘are you too old for this,’ but ‘what do you want to get back to, and
what’s the best way to get you there?'”

Two people the same age can have very different paths forward depending on their injury,
their goals, and the rest of their health picture.

3. For some older patients, avoiding a graft can be meaningful

The most common surgical treatment for an ACL tear is ACL reconstruction (ACLR), which
replaces the torn ligament with a tendon graft taken from the patient’s own leg or from a
donor. The BEAR Implant takes a different approach, helping the patient’s own torn ligament
heal instead of replacing it. For some older patients, that distinction carries weight.

“They benefit by avoiding the need for a potential graft donor site to heal, a less invasive
procedure, and a short surgery time,” Dr. Mickelson says. “Since every decade the body
takes a bit longer to heal, this provides a benefit for older patients and helps get them back
to the things they enjoy sooner.”

4. The only way to know is to ask

There is no age cutoff you can look up that will give you a yes or a no. The biggest
misconception patients bring in is that reaching a certain age automatically limits their
options.

“I have 30-year-olds who aren’t great candidates for certain procedures and 65-year-olds
who are excellent candidates,” Dr. Nathe points out. “Chronological age is one data point; it
isn’t the whole story.”

Surgeons weigh the full picture instead.

“Patient goals, medical issues, additional injuries within the knee, as well as ACL tear type
and location are all taken into consideration,” says Dr. Mickelson.

“The right conversation is about your goals and your overall health, not the year on your
driver’s license,” Dr. Nathe says.

BEAR Perspectives: Real Patients, Real Decisions

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Key Takeaways

• The BEAR Implant has no upper age limit. Eligibility is determined by the quality of a patient’s remaining ACL tissue rather than by age.
• BEAR Implant candidacy depends on tear type, remaining ligament tissue, timing of the injury, and overall knee condition.
• Since FDA approval, 34 percent of BEAR Implant procedures have been performed in patients age 35 and older.
• Avoiding a tendon graft can be meaningful for patients whose bodies heal more slowly.
• In choosing between the BEAR Implant and ACLR, your goals and overall health drive the decision, in consultation with a surgeon.

Learn More About the BEAR Implant and Find a Surgeon

The BEAR Implant is available across the U.S. Learn more about the BEAR Implant, read additional patient stories in the Comeback Community, or find a surgeon in your area.

The BEAR Implant from Miach Orthopaedics was approved by the U.S. Food and Drug Administration in December 2020. It is indicated for adults, adolescents and children with a complete or partial rupture of the ACL, as confirmed by MRI. Patients must have an ACL stump attached to the tibia to construct the repair. Children with open physes must have sufficient bone in the femoral and tibial epiphyses on either side of the intended tunnel locations to avoid disruption of the growth plates.

It is important to follow the BEAR Implant physical therapy program. Your surgeon can explain the program details.

Be sure to discuss your individual symptoms, diagnosis and treatment with your surgeon. The BEAR Implant has the same potential medical/surgical complications as other orthopedic surgical procedures, including ACL reconstruction. These include the risk of retear, infection, knee pain, meniscus injury and limited range of motion.

Visit www.miachortho.com for complete product information, including Instructions for Use.

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