Curtis Karwacki is a 32-year-old teacher who also trains and competes in jiu jitsu and mixed martial arts (MMA). When he tore his anterior cruciate ligament (ACL) during a sparring match, he was committed to finding a treatment option that could help him get back to high-intensity sports that required constant use of his knee. During his research on alternative options to ACL reconstruction (ACLR), he was introduced to the BEAR^® Implant as a way to repair his native ACL. We connected with Curtis and his orthopedic surgeon, Dr. Marc Pietropaoli (Dr. P), orthopedic surgeon at Victory Sports Medicine & Orthopedics in Skaneateles, NY, about why he chose the BEAR Implant, how rehab went and how the BEAR Implant has helped him along his personal health and fitness journey.   

Q: How did you tear your ACL? 

Curtis: I tore my ACL while going too hard and overdoing it during a back-to-back morning CrossFit and jiu jitsu session. While sparring at the end of class with a larger opponent, I didn’t follow through with my position after hitting a double ankle sweep. My opponent wrenched my leg to attempt to get back in a top position, and in the process, I felt and heard a pop in my knee. Since the adrenaline was pumping, I continued the session, but after I stood up, my left knee felt wobbly. The next morning, my knee would get stuck when I hyperextended it, and although I wasn’t in pain, it felt mildly stiff and unstable. Two weeks later, I decided to get an x-ray and MRI, which confirmed I tore my ACL.

Q: How did you learn about the BEAR Implant? What made you decide it was the right choice for you? 

Curtis: I initially went to another orthopedic surgeon to see what ACL treatment options were available. I was emotional about removing my torn ACL and weakening another part of my body through ACLR with a patellar tendon or quad graft. Forgoing surgery and adapting to living with the torn ligaments was also unappealing given I needed to be on my knees a lot for jiu jitsu and MMA. My best friend, who is a physician’s assistant, ended up introducing me to the BEAR Implant and referring me to get a second option with Dr. P. Before I met with Dr. P, I started researching the BEAR Implant and watching YouTube videos about the procedure. I chose the BEAR Implant because it would allow me to retain my own ACL, helping me keep the proprioception of the ligament, and it seemed less invasive than ACLR.

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

Dr. P: Curtis was a highly motivated and educated patient who did his research on ACL tears and different types of surgeries such as ACLR and the BEAR Implant. Since he’s very athletic and competes in Brazilian jiu jitsu and MMA, he wanted to get back to as full strength as possible by keeping his own native ACL and avoiding using donor tissue.

Q: Can you tell us more about rehab?

Curtis: The first few days of rehab were rough because I was in a lot of pain post-surgery, and I felt foggy and hazy while on pain medication. After that, I really hit my stride and was consistently working as hard as I could two to three days a week. Because I had to take it easy on my knee, I put a lot of effort into working out my arms, doing hundreds of sit ups and reverse leg curls. I focused on getting my functional strength back versus high intensity workouts. Mentally it was also tough because it felt like a lot of time was being robbed from me, and it was necessary to take a significant time off from training jiu jitsu or martial arts. I was initially concerned I wouldn’t ever be the same, but at the end of my rehab, I was able to do everything I did physically before surgery. My BEAR Implant knee looked almost identical to my other knee, and both flexibility and mobility went back to normal.

Dr. P: When it comes to rehab following BEAR Implant surgery versus ACLR, BEAR Implant patients must go slower the first six to eight weeks because the “biology is still the biology” while the BEAR Implant is holding the two torn ends of the ACL in place. Curtis progressed with his rehab and activities a bit quicker and sooner than we would normally recommend, such as kicking a metal bar to practice getting his leg in shape for kicking while fighting jiu jitsu and MMA. Similar to what we’ve seen with ACLR rehab, some patients like Curtis who progressed faster during BEAR Implant rehab actually had better outcomes overall. With this in mind, we may eventually consider speeding up the BEAR Implant rehab someday, but for now we still recommend the rehab protocol we prescribe.

Q: Can you tell us about your return to sport?

Curtis: I was cleared to return to sport one-year post-surgery, and I competed in combat jiu jitsu against another blue belt four days later. I was nervous and excited before my match. Although I had a strong first round, I got caught in a triangle hold in the second round. At that point in time, my ability to train all day wasn’t there yet so I continued to work on my conditioning and heart rate. Even though I didn’t win, this first match was proof of concept that my knee was fine. A few months later I came back and won a gold medal. Combat jiu jitsu is a beautiful transition sport that bridges the gap between jiu jitsu and mixed martial arts. My goal is to continue training in these sports and eventually become a black belt in jiu jitsu.

Q: Have you observed anything new about the BEAR Implant in your most recent cases? 

Dr. P: As I continue to perform BEAR Implant surgeries, I have seen it can pretty much be used with all types of ACL tears. These include full thickness, partial thickness, proximal, mid-substance and distal; acute, subacute and even chronic – as long as there is enough tibial stump to secure the stump sutures.

Q: Do you have any advice for patients who have torn their ACL?

Curtis: My advice for anyone who has torn their ACL is to research all the treatment options available and don’t just go for the first option you’re offered. Getting surgery doesn’t fix all your problems, it makes the pathway to achieving your fitness goals more grooved.

Q. Has your decision to get the BEAR Implant changed your life or impacted your daily life in any way?

Curtis: The BEAR Implant helped me during a vulnerable time of my life when I wasn’t sure if my ACL tear would compromise my ability to get back to mixed martial arts at the level that I was at before my injury. Today, I don’t even think about my knee and I’m even running seven miles in one go for the first time in 10 years. I am living proof that the BEAR Implant works, and I am able to do everything I used to prior to my injury. I feel supremely confident in my knee and am continuing to make progress in my physical health journey.

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 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-1184 Rev A 10/2024