Physical therapist Zach Mitchell, 36, is now three years out from receiving the BEAR^® Implant. To celebrate this milestone, he completed a life-long goal of competing in an IRONMAN triathlon. Zach previously provided an update at 6-months post-surgery. More recently, we chatted with him to understand how his background as a physical therapist influenced his decision to get the BEAR Implant, how his return to sport went at the one-year mark and what it was like completing an IRONMAN.

Not His First ACL Tear Experience

Zach first tore his anterior cruciate ligament (ACL) playing college rugby and underwent traditional ACL reconstruction (ACLR). More than a decade later, he would end up sustaining a more significant injury to his other knee during an adult soccer league game. Zach was chasing down a long ball when the defender deflected the ball at the last second, causing him to rapidly change direction. He immediately felt a sharp pain in his knee and knew something was wrong.

However, with his adrenaline racing, he decided to tape up his knee and continued to play until he was sidelined with a second injury he couldn’t play through. Although his team ultimately won the championship game, his celebration included a visit to the emergency room. After getting an MRI, he was diagnosed with a complete ACL tear, partial tear of his PCL and MCL, a lateral meniscus tear, and a bucket handle tear of his medial meniscus.

“Research shows that about 50% of patients who tear their ACLs also tear their meniscus at the same time; however, my bucket handle and lateral meniscus injuries were very severe,” Zach said. “Given the severity of my injuries, I knew my knee might never be the same. It was a humbling process to accept, but I knew the only way to get out of this situation would be surgery, rehab, hard work, goal setting, patience, and topping that off with faith that everything would work out.”

Why Zach Chose Restoration Over Reconstruction

As a physical therapist having worked with many patients recovering from ACLR surgery and based on his own positive experience with his previous ACLR surgery, Zach initially considered getting ACLR again with a patellar tendon graft. However, he wanted to explore all options. Through one of his patients, he found Dr. Richard Levine, a sports medicine orthopedic surgeon at MedStar Union Memorial Hospital in Baltimore, who introduced him to the BEAR Implant.

“When I learned about the benefits of the BEAR Implant – ACL restoration instead of reconstruction – it made a lot of sense,” Zach said. “I saw it as a new evolution of treating ligament tears. I did my own research, and I ultimately chose the BEAR Implant because restoring my original ACL would cause less damage to the knee than cutting it out and replacing it with another graft. In addition, I was informed that the restoration with the BEAR Implant would be as strong as the other ACLR grafts and would have a similar return to sport timeframe.”

Rehab Helps Zach Get Back to Sports

After getting the BEAR Implant surgery, Zach embarked upon his rehab and recovery journey. Compared to his previous ACLR rehab, the BEAR Implant rehab protocol was slower and more conservative in the beginning. He knew the importance of following the protocol to avoid laxity in the ACL, breaking the bridge or compromising joint preservation.

By the six-to-nine-month mark, he started to hit his stride. He was fully functioning at work and began working on plyometrics and cutting. At one-year post surgery, he returned to playing low-intensity pick-up soccer games and later moved to playing in a more competitive league. Zach also returned to snowboarding double black diamonds, through tree lines, and moguls without any issues.

Although he has fully recovered from the BEAR Implant surgery in his left knee, he still has some discomfort and swelling from his severe bucket handle meniscus tear and unrepaired lateral meniscus tear; however, he was able to return to all the activities he was doing before the injury.

“Through many years working with patients and my own recovery, I feel fully confident in my restored ACL,” Zach explained. “The only thing that bothers me is my damaged menisci, but overall, my BEAR Implant knee is strong. I’m very confident in my knee and have no difficulty changing directions, cutting or jumping. The only difference is I now have a mindset shift. I’m not as aggressive when playing sports because I want my knees to last as long as possible. Being physically active with my kids, playing soccer with my wife and in-laws, and not getting injured are my top priorities.” 

Fulfilling a Lifelong Goal to Complete a Triathlon and Ultramarathon

Last year, to celebrate his three-year anniversary of getting the BEAR Implant, Zach decided to enter an IRONMAN competition and Ultramarathon. He had been training for a full IRONMAN his senior year of college and had to put it on hold when he tore his ACL the first time. Being able to complete an IRONMAN was still a goal, but he had put it on the backburner as he accomplished his other goals of becoming a physical therapist, getting married and growing his family. After learning he was expecting his third child last year, Zach decided it was time to finish what he had started over a decade later.

“I completed the Maryland IRONMAN in 14.5 hours, and although my BEAR Implant knee had discomfort after the race due to the meniscus damage, it held up strong during the race,” Zach said. “I feel really excited to have finally achieved my lifelong goals of competing in an IRONMAN as well as the JFK 50 Mile race. I couldn’t have accomplished this without the support of my wife and daughters through this journey.”

Zach Recommends Considering Athletic Goals When Selecting ACL Tear Surgery

“I would definitely recommend the BEAR Implant to people exploring their ACL surgery options,” he said. “There are pros and cons to every procedure, and it’s important to consider your goals for the future. For me, if I can have similar or even better outcomes with a procedure that is less invasive and allows me to preserve my original ACL, it’s a no-brainer to choose the BEAR Implant.” 

Today, Zach continues to be physically active with his kids, plays soccer with his wife and in-laws, runs his physical therapy business, and enjoys training for new challenges.

Learn more about the BEAR Implant

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. If you’re a physical therapist and would like more information about the BEAR Implant rehabilitation program, click here.

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-1221 Rev A 4/2025