Joey Marcella was only 8 years old when he tore his anterior cruciate ligament (ACL) during a football game. Due to his very young age, his parents were concerned about ACL reconstruction (ACLR) interfering with his growth plates and sought to find a less invasive option. Through their own research, they found Dr. Sean Keyes, a pediatric orthopedic sports surgeon at AdventHealth for Children in Orlando, Florida, to discuss how the BEAR Implant could help Joey return to his normal life and get him back to playing sports.

We spoke with Joey, who is now 10, and his mother Chelle, who is a former Olympic gymnast, about why they chose the BEAR Implant, how rehab went and what Joey’s goals are. Dr. Keyes provided his insight into how the BEAR Implant has changed his treatment recommendations and what young athletes should consider when evaluating ACL surgery options.

Q: How did you tear your ACL? 

Joey: I was the quarterback for my football team, and during a game, I was running out of pocket and someone pulled me from the back, and I felt a snap. My knee kept shifting every time I would walk. We went to the doctor right away, and he confirmed my ACL tear with an MRI. It was scary because I thought an ACL tear was a lifetime tear and I thought I wouldn’t be able to play football again.

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

Chelle: After we found out Joey tore his ACL, my husband started looking online for the best surgeon. I’m a former Olympic gymnast and he is a firefighter and paramedic, so we are both very familiar with sports injuries. We looked into ACLR and knew that it wasn’t the best option for young children because the surgery involved drilling into the growth plates. Joey was only 8 years old and was an extremely active child who played multiple sports and rode dirt bikes. We knew it wasn’t an option to not treat the ACL tear. As we researched what less-invasive options were available, we came across the BEAR Implant. My husband’s colleague’s wife happened to work with Dr. Keyes and introduced us to him.

We ultimately made the decision for Joey to get the BEAR Implant because of its ability to help Joey heal his own ACL and to avoid drilling into his growth plates. We wanted to give both legs a chance to mature evenly and also protect him from having to undergo such an intense surgery as ACLR. Even though he was young, Joey was well informed about the differences between the two surgeries.

Q: How do you address common questions pediatric patients and their parents have about the BEAR Implant?

Dr. Keyes: My parents and families are pretty well researched and educated when they come into the visit about their ACL tears. A lot of them are looking to me to determine if they are a candidate for the BEAR Implant, and they are hopeful that they are. What often makes the most impact is when I explain how the BEAR Implant provides a stable environment inside the knee to allow for ACL healing.

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

Dr. Keyes: Joey was a good candidate for the BEAR Implant because of his motivation to have a stable knee and return to sports.  Additionally, the alternative treatment options because he was so young were to either wait until he was older, or to restore stability to his knee with his IT band in a non-anatomic fashion. Having the BEAR Implant was great because it minimized the surgical footprint around his growth plates while allowing him to restore the native stability to his knee.

Q: What, in your opinion, is most notable about the BEAR Implant when it comes to pediatric patients?

Dr. Keyes: Surgery to fix an ACL tear is different in children because we are concerned about causing damage to the growth plates, which can lead to issues such as limb length discrepancies and angular deformities. The BEAR Implant allows us to restore the ACL to its original, natural state while preserving the growth plates. We believe this will improve the long-term health of the knee.

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

Dr. Keyes: One minor difference in how I treat my BEAR Implant patients is that I immobilize their knees straight for 2 weeks. The main reason for this is to prevent a flexion contracture, or having their knee be stiff in the bent position. An additional benefit for patients is that by minimizing motion in the knee initially, it allows the clot to stabilize and minimizes theoretical migration and allows for provisional healing. 

Q: How was the rehab experience?    

Joey: I thought rehab would be harder than it was. It hurt at first, but I got through it. I knew I wanted to get my right BEAR Implant knee to be equal strength as my left knee. My parents explained that if I went too hard, my ACL could pop again. The first 30 days were hard for me, and it was annoying to have to wear the brace. I also couldn’t bend my knee at first and had to go to school either in a wheelchair or using a walker. As the days went by, I got more comfortable doing the rehab exercises because I knew what to expect.

Chelle: Supporting Joey through recovery was harder once he graduated to doing the rehab exercises at home. It was difficult for him to understand that it took a lot of effort to get the knee back to its full physical strength. We were concerned that since his BEAR Implant knee was reinforced, his other knee would be more susceptible to injury if he went back to playing sports too soon. Since he was sitting a lot, he experienced a lot of atrophy in his muscles. With my sports background, I knew we had to approach rehab the right way. At 8 years old, it was challenging, and we had the drive the process for him. He put a lot of work into understanding and complying with the program.  

Dr. Keyes: Joey is highly motivated and has the personality to go 100 mph when he’s feeling good. Since he started to feel good very early on – thanks in part to our excellent physical therapists – we had to slow down while recognizing his eagerness to constantly improve. 

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

Dr. Keyes: What I notice most about the BEAR Implant is how normal the patients feel when compared to ACL reconstruction patients. Having the BEAR Implant available has allowed us to expand our ability to reliably repair ACLs.  Patients who otherwise would have an ACL reconstruction or replacement are now given the ability to restore their native tissue.   

Q: Can you tell me about your return to football?

Chelle: When he first returned to football, he was cautious. Since he was still wearing the brace, it was hard to tell how much of his soreness was due to the tightness of the brace versus actual pain. Being so young, it was important for us to not push him too fast or let him go too hard. We wanted him to have more time to fully recover. Joey always goes all in because he’s so passionate, but we pulled him back to play second string so we could reduce the risk of him retearing his ACL. We plan to have him continue to wear his brace to provide support and reduce the risk of a retear.

Q: How does your BEAR Implant knee feel today?

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

Chelle: Yes, we would recommend the BEAR Implant to others. For a child whose life revolves around sports, the BEAR Implant has so many benefits besides its ability to help heal your own ACL. He plays pop warner football, baseball and also wants to get into soccer, basketball and swimming. As a parent looking into ACL tear treatments for your child, it’s important to do your research to limit the amount of intrusive surgery that might hinder their growth. We are grateful for this technology, which has allowed Joey to get back to his active life as it was before his injury.

Q: What are some of your future goals?

Joey: I want to be a star in the NFL. I want to play like Tom Brady; except I want to play for Michigan or Oregon. I really connect to the lyrics in this country song, “If you have a dream, chase it. Because it won’t chase you back.” Without the BEAR Implant, I wouldn’t be able to achieve my future goals.  

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 09/2025