Bridge-Enhanced Anterior Cruciate Ligament Repair (BEAR): New Promise for ACL Repair?

Anterior Cruciate Ligament (ACL) repair versus reconstruction–which is best for surgically indicated patients with ACL tears? For the last few decades at least, the answer has largely been reconstruction. It comes as no surprise, after all, ACL reconstruction has a much larger evidence base and proven track record. Ultimately, reconstructing the ACL results in a stable tissue less prone to retear. Yet, even gold standards have room to improve. ACL reconstructions, for example, often require autograft harvesting which can mean patients are left with donor site morbidity and pain – and longer recovery times. (1-3) The non-native tissue also lacks the biological properties of the native ACL which could inhibit the recovery of proprioceptive capabilities. (1-3) The procedure also requires larger, more invasive bone tunnels which can put patients at risk of developing early onset osteoarthritis. (1-3) All things that could be avoided, or minimized, through conservative management or ACL repair. This discussion is further complicated by other factors such as tear type, age, activity level, physical therapy protocol, and a relatively new array of alternative surgical procedures – which approach benefits select patients most? In this OE Original, we explore some of the evidence comparing ACL repair to reconstruction and discuss one new approach to ACL repair, Bridge-Enhanced Anterior Cruciate Ligament Repair (BEAR), that could reignite this debate once more.

Personalized Joint Replacement Surgery: The Hype, Hope & Hard Evidence

Instead of the typical “one-size-fits-all” approach to patient care, personalized medicine aims to improve clinical outcomes, reduce complications, and enhance patient satisfaction by tailoring treatment strategies to the unique genetic, anatomical, and lifestyle characteristics of each patient. As healthcare systems increasingly prioritize individualized care, surgical disciplines like orthopedics are beginning to embrace this paradigm shift.

Ozempic in Orthopedics: Weight Loss Miracle or a Musculoskeletal Risk?

GLP-1 receptor agonists such as semaglutide and liraglutide have surged in popularity for weight loss, prompting growing interest in their musculoskeletal effects. Evidence suggests potential benefits for patients with osteoarthritis, including symptom improvement and reduced need for arthroplasty, though some data indicate a possible increased OA risk in those without prior disease. GLP-1 RAs may also reduce bone mineral density, yet paradoxically appear to lower fracture risk in individuals with type 2 diabetes. In surgical settings, GLP-1 use has been linked to fewer complications after hip and knee arthroplasty, but may raise perioperative risks in shoulder surgery. Overall, these medications show promise but require cautious use and further long-term study to clarify their impact on bone and joint health.

OE Top Trends for 2025

Orthopaedic research in 2024 marked a shift in focus, with extremity care and sports medicine drawing more attention than arthroplasty. Landmark studies highlighted iodine-alcohol antisepsis reducing surgical site infections, combined strength and balance training improving chronic ankle instability, and rapid rehabilitation lowering complications after hip fractures. Explorers—those at the forefront of research—showed heightened interest in platelet-rich plasma formulations, digital rehabilitation strategies, and long-term outcomes of surgical innovations. Looking to 2025, the field is set to expand into AI-assisted imaging and diagnostics, 3D-printed custom implants, and the growing role of digitized care. Meanwhile, GLP-1 therapies for weight loss may emerge as powerful tools in perioperative management and osteoarthritis prevention. Together, these trends suggest a rapidly evolving landscape where biologics, technology, and digital health converge to redefine musculoskeletal care.

3 Non-Pharmacological Approaches to Managing TKA Pain

Total knee arthroplasty (TKA) is frequently associated with significant postoperative pain, often managed with opioids despite well-documented risks of adverse effects and dependency. There is evidence for three non-pharmacological strategies; Cryotherapy demonstrates a consistent capacity to reduce pain, though its impact on opioid consumption appears modest and context dependent. Acupuncture shows potential benefits in intermediate and late recovery phases but offers limited and inconsistent evidence for reducing opioid use. Continuous passive motion, by contrast, confers minimal analgesic or opioid-sparing benefit while increasing costs and hospital stay. Barriers to adoption—including economic, logistical, and clinical challenges—further constrain their utility. Collectively, these findings highlight both the promise and limitations of current alternatives and underscore the importance of a multidisciplinary approach that combines pharmacological and non-pharmacological strategies to optimize pain control while addressing the broader challenges of opioid stewardship in TKA care.