When Sawyer Monik was just 13 years old, a hard hit during a football game left him with a torn anterior cruciate ligament (ACL)—a devastating injury for a young athlete who had been on the football field since first grade. Faced with the reality of surgery, Sawyer and his family began looking into less invasive surgical options than traditional ACL reconstruction (ACLR). Their search led them to the BEAR^® Implant, an approach that restores the patient’s native ACL, enabling the knee joint to function more naturally. For Sawyer, choosing the BEAR Implant meant more than just repairing an injury in the short term; it was about reclaiming his ability to cut, run and play the sport he loves in his prime.

We spoke with Sawyer and his father Lou about why they selected the BEAR Implant and how his knee is doing two years after surgery, as well as to Sawyer’s surgeon, Dr. Peter Maiers, a sports medicine specialist at Forté Sports Medicine and Orthopedics in Carmel, Indiana, about why he recommends the BEAR Implant over ACLR for young athletes like Sawyer with open growth plates.

Q: How did you tear your ACL? 

Sawyer: I first hurt my knee during a football game after getting hit weird. The following game, I fell down after my knee gave out while running. I had pain for a week or two, and my knee was swollen. I tried to play the next game wearing a knee brace, but I was in so much pain. The next day, I got an MRI, which showed that I tore my ACL and part of my meniscus. I initially thought about what this meant for football, but I didn’t let it get to me. I wanted to focus on getting back and ready to play as soon as I could.

Q. What treatment options did you explore and why did you choose to move forward with the BEAR Implant?

Lou: A lot of the guys I work with had ACL tears, so I asked them how their knees were doing now that it’s been years since their surgery. I got feedback that some of them were still experiencing issues, so I wanted to see if there were alternatives to traditional ACLR to protect the long-term health of Sawyer’s knee. When I started Googling top ACL surgeries, the BEAR Implant came up in my search. I was very interested in how it could help heal the ACL. When I took Sawyer in for a consultation, Dr. Maiers also brought up the BEAR Implant, and it turns out we were on the same page because Sawyer was so young and still had open growth plates. We thought the BEAR Implant would be a better option because it was a less invasive surgery that could help him heal his own ACL, and we could still resort to other options like ACLR if he retore his ACL in the future.

Q: Why was Sawyer a good candidate for the BEAR Implant?

Dr. Maiers: I think the BEAR Implant is an ideal choice for patients like Sawyer with open growth plates who desire to return to high level athletics. The BEAR Implant was a reasonable choice that would allow his knee to return to normal function without having to harvest a graft. Furthermore, he was willing to put in the time and effort in rehab before returning to sports.

Q: What unique considerations are there for young athletes like Sawyer when it comes to the BEAR Implant vs. ACLR?

Dr. Maiers: The BEAR Implant has been very predictable and has allowed kids to return to high-level athletics. Young athletes with open growth plates have a tremendous ability to heal but unfortunately, they are generally at a higher risk of re-injury because they have more exposure and are participating more frequently.

One of the things I really like about the BEAR Implant is that it does not burn any bridges and can potentially serve as a bridge procedure if they end up tearing their ACL again. If Sawyer should have another ACL injury, we can still utilize a patella tendon graft, which is the gold standard. However, if someone had undergone traditional ACLR, a revision surgery would be more challenging if they’ve already had ACLR as opposed to a BEAR Implant procedure.

Q: What are the most common questions pediatric patients and their parents have about the BEAR Implant and how do you address any concerns?

Dr. Maiers: They typically ask about re-injury rate as well as when they will be allowed to return to sports. The literature has proven that the re-injury rate is similar to that of a traditional reconstruction with a hamstring autograph. As far as return to sports, I tell them we hold off until at least nine months after a BEAR Implant procedure, which is a slightly longer timeframe than with a traditional ACL reconstruction.

When children tear their ACLs, it can be a very challenging situation for the entire family. The BEAR Implant can give young athletes the opportunity to come back and play at the same or higher level that they were prior to their injury. In my opinion, the BEAR Implant is a very safe and effective way to help children dealing with this very difficult injury to get back to doing what they love. 

Q: How was the rehab experience?    

Sawyer: Rehab surprised me because it was really slow at first. We focused on little movements here and there. After three or four months, I started doing more normal exercises, and I started jogging around five or six months. Physical therapy was a long process, but it felt good whenever I got to start a new activity. Mentally, it kind of hurt because I had to watch everyone else play the sports I love. I wished the whole time I was able to play football, but I knew I needed to sit back and wait it out while my knee was recovering.

Lou: Sawyer’s mom Sarah took Sawyer to every single physical therapy appointment. Since he was only 13 at the time, it was challenging getting back and forth every day while also nudging him gently to do the physical therapy on his own at home. He didn’t always feel like doing the exercises at home, but he understood the importance of it and followed through. We didn’t realize the rehab protocol was a little slower at the beginning compared to ACLR, so the instructions were really helpful so we could understand where he should actually be in his recovery. 

Dr. Maiers: The BEAR Implant surgery is really the easy part. The reason that Sawyer was able to get back to football 10 months after surgery is because he dedicated himself and worked really hard through the rehab process. It was his hard work and diligence that made the difference.

Q: Can you tell us about how you first got into football? How did your return to football go? 

Sawyer: I started playing football in first grade since my brothers and all my friends were playing too. I like being a quarterback because I am the leader of the team and it’s a good feeling when people look up to me. My goals with football are to become one of the top players on the team and also to be a mentor to help other kids get better since I always looked up to the upperclassmen.

I was cleared to return to football at 10 months after surgery. I started out doing some hitting drills during practice, but it didn’t feel like I was really back until the first game. I felt a little nervous when I remembered how bad it felt when I first tore my ACL. I took some hits during the game, but none of them really bothered me. I would sometimes think about being scared to get hit in the knee, but after the game, I felt perfectly fine. My knees felt the same and there was only a little bit of soreness from going 110% and playing hard.

Lou: We were on pins and needles Sawyer’s first game back, especially when he took that first hit and got back up. I give him a lot of credit because after a sports injury, getting back up is one of the hardest things to overcome. In your mind, you may be favoring your knee because you’re scared to reinjure or injure the other knee, but Sawyer gave it his all.

Q: In your opinion, what is most notable about the BEAR Implant?

Dr. Maiers: I like that the BEAR Implant allows us to restore the integrity of the ACL without having to utilize a graft. For years, autograft ACL reconstruction has been the gold standard, particularly with a patella tendon autograft. However, there can be donor site morbidity associated with this. An allograft (donor tissue) eliminates the morbidity, but there is a higher re-injury rate associated with allograft tissue, so it is typically not used for younger athletes.

Q: How has the BEAR Implant impacted how you treat ACL tears?

Dr. Maiers: I have utilized the BEAR Implant in patients who are not a candidate for a patella tendon reconstruction because their growth plates are still open, are willing to accept a slightly longer rehab time, do not want to either have an allograft or are unwilling to accept the potential comorbidities associated with harvesting an autograft. I also look for patients with proximal ACL tears where we have good tissue to sew to.

Q: As a parent, why would you recommend the BEAR Implant to others considering ACL surgery options for their child?

Lou: As a parent of a young child, our focus was not just on the short-term recovery but really the long-term impact onthe health of his knee. We stand by our decision as a family to get the BEAR Implant for Sawyer because even though the recovery was slower in the beginning, he was able to heal his own ACL instead of replacing it. We didn’t want to take a chance on ACLR and potentially have him be limited later in life.

Q: What are some of your milestones since returning to football and what are some of your future goals?

Sawyer: I was the quarterback on my team freshman year and I’m continuing as quarterback for the varsity team. For the next three years, I want to have my knee last and play without worrying about potentially getting injured. Being able to go back to playing football after my ACL tear is one of my biggest accomplishments, and I plan to continue playing through high school. After high school, I am going to get into electrical line work like my brother and my dad because I like being outdoors. 

Q: How has getting the BEAR Implant changed your life?

Sawyer: I don’t think about my BEAR Implant knee anymore. I just know that I have two normal functioning knees, and I trust them to hold up. It’s been an emotional experience because it was a long process, but I’m glad my knee feels the same as it was before.

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 or find a surgeon in your area. If you’re a parent considering the BEAR Implant for your child, click here for more information.  If you’re a BEAR Implant patient and would like to share your story, click here.

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 re-tear, infection, knee pain, meniscus injury and limited range of motion.

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

ML-1284 Rev A 10/2025