AMBIGUOUS RESULTS

Miach's BEAR implant registry shows 5% ACL retear rate at two years

Modified surgical technique tracked with the same 5% retear rate seen in a published 100-patient cohort and cut reoperations, but the Bridge Registry has no comparator arm.

By AppliedXLJuly 8, 2026Trial NCT05398341

Executive Summary

Miach Orthopaedics reported that two-year outcomes from an expanded patient group in its ACL implant registry are tracking the retear rate already published for an earlier, smaller cohort, extending a single-arm safety and effectiveness signal rather than establishing a new one.
The company also reported that a modified surgical technique tracked with fewer reoperations than the original technique, with no change on other measured safety outcomes, a secondary finding that reinforces the durability read on the primary retear signal.
The registry carries no comparator group, so the results describe how this implant performed on its own rather than how it performed against ACL reconstruction, the established alternative.
The result matters because it is the largest outcomes disclosure yet for an implant that aims to let orthopedic surgeons preserve the native ACL instead of replacing it with a graft, and the field around it has no other registrational-stage restoration implant of the same design on file.

The disclosure

Miach Orthopaedics presented the update at the American Orthopaedic Society for Sports Medicine's annual meeting, held July 8 through 11, 2026 in Seattle. The company said two-year outcomes for the 200-patient group are tracking the same 5% retear rate reported for a 100-patient cohort recently published in the Video Journal of Sports Medicine. The Bridge Registry, registered as NCT05398341, has enrolled 300 patients since it opened in May 2023. No results have been posted to the registry's own results section for the trial. BEAR+1

The technique change

Dr. Jocelyn Wittstein, an orthopedic surgeon at Duke University and co-investigator on the Bridge Registry, said refinements to fixation and suture technique "can have an impact on patient outcomes," adding that the modified approach "was associated with a lower overall reoperation rate than the original technique, with no difference in other safety outcomes". That reoperation finding comes from a comparison of surgical technique versions within the registry's own patients, not against a separate control arm treated with ACL reconstruction. BEAR

The stake

The BEAR Implant is positioned as an alternative to ACL reconstruction, the standard surgical repair for a torn ligament, letting surgeons restore the native ACL rather than replace it with a tendon graft. Miach said nearly 10,000 patients have now been treated with the implant. Across ACL-focused device trials with disclosed registry data, seven active studies span 460 total enrolled patients, and Miach itself sponsors three of those, including the Bridge Registry. No other ACL restoration implant of comparable design and enrollment scale appears among the remaining trials, which cover artificial ligament, cartilage, and meniscus devices rather than the same restoration approach. BEAR

Reading the result

The registry has no comparator arm, so the retear and reoperation figures describe this cohort's own trajectory rather than a difference against reconstruction or against an earlier BEAR Implant surgical technique measured in a controlled design. The disclosure also draws its reoperation-rate improvement from a subgroup that used the modified technique, not from the full 300-patient enrolled population. Those two features limit the disclosure to a descriptive update: the retear rate held across two successive cohort sizes, but the trial design does not let that consistency stand in for a controlled effectiveness result. BEAR

This analysis was produced using AI-assisted reporting systems, AppliedXL data, and official public records. These systems undergo editorial review, quality checks, and regular audits by human experts. Errors may still occur, as with any automated system. Always consult the linked primary sources. Read our AI Editorial Policy.