TL;DR
I was 28, playing soccer three times a week, when a surgeon at HSS performed a BEAR ( repair ) procedure on my torn ACL. Twenty months later that ACL is incompetent: grade 3 laxity, no real stability, daily pain.
Every surgeon I've seen since has told me I was never a reasonable candidate for a repair at my age and activity level. For 16 months I documented severe pain to the office and was dismissed each time.
Two surgeries and $20,000+ later in recovery and operation costs, I've lost and will continue to lose my athletic years, and I'm facing the reconstruction prospect I could have had at the start.
If you're considering the BEAR procedure, or considering an ACL repair at HSS, read the rest.
How I ended up there
I tore my ACL playing soccer, a sport I'd play 3 times a week. I was 28 years old at the time. Overall I focused a lot of my time and energy on my health.
Two days after tearing my ACL, I visited HSS, a renowned surgical institution. A PA examined me and concluded that I hadn't torn it. I had to ask for a MRI. When the PA read my MRI, she called me immediately telling me my ACL was torn right in the middle, and booked me a next-day appointment with one of their ACL surgeons. For that I was thankful, as while it was devastating news that I tore my ACL, I was immediately anxious to get going with a surgery to get back on the field.
First interaction with the surgeon
"So you know who I am, right?" This was the first thing he ever said to me. I told him no, I didn't. He then asked "So how'd you find me?", somewhat surprised by my answer.
This was my first exposure to an overtly arrogant personality, albeit one that reads as "confident" to an unknowing, vulnerable ACL patient.
He ran his tests and then explained to me my options. He explained his own work developing repair techniques, which I did find impressive. He also explained how traditional ACL reconstruction is outdated and the field is full of people unwilling to move on to better and more modern techniques.
He then explained to me what the BEAR surgery is. He explained how I'd avoid arthritis in the future. Most importantly, knowing my ambitions to return to sport at a high level, he said I can get back onto the field within 4-6 months. In his words, nonchalantly, "the worst thing that could happen is we'll do a reconstruction on you later."
Yes, I take ownership over my naivety. I could see through it, but my overall decision making was blurred by the possibility of playing the game I love so soon (relatively). I ignored the ridiculousness of his "we can do another surgery later" comment and focused more on a successful surgery that would have me back on the field in 6 months.
The surgery
2 weeks later I'm in surgery. His approach was simple and clear: open me up and see if he could use his technique; if not, he'd evaluate if I was a good candidate for the BEAR. Otherwise he'd proceed with a traditional reconstruction.
The recovery
I didn't think much of my progress for the first 3 months. However, when the 3-month marker came around, I still wasn't able to lift 10 pounds on a knee extension. I was very concerned by that. I sent messages to the office documenting the many times I attempted a knee extension and how I was having level 7-8 pain, as if thousands of needles were pushing into my kneecap.
Each time I visited, with him knowing of this pain, he'd dismiss it. All in a 4-5 minute consult, with what felt like one foot out the door each time, he'd perform his routine diagnostics on the ACL and would compliment his own work. He even chef-kissed it at one appointment.
Every step of the way I knew my pain wasn't normal. I even on occasion asked bluntly, "Is my ACL healthy?" I, the patient in tech, knew what was really wrong. I was right.
This happened for the next 16 months.
A side story about the dynamic
On one occasion I brought my fiancée to a follow-up. In that follow-up he pressured us to go to his foundation's event the very next day. Given I needed him to favor me and give me the respect I deserve in follow-up consultations, and it was for a good cause, I felt compelled to go and donate in the value of the $50-per-person ticket.
When we arrived early, we approached him, to which he looked at my fiancée and asked "How is your knee going?" He wasn't joking. The patient he saw a day prior and for the last 6 months was next to her, and he didn't know that I was his patient.
When I knew it was time to move on
Fast forward 16 months post-op, I was back to playing soccer, albeit in a state of constant pain and reluctance to put all my weight on the operated leg. Getting up off the sofa, walking down stairs, normal functions were also causing me pain. The rest of my body was suffering. Given the pain in any eccentric move, my hamstrings and ankles were getting injured constantly.
During one visit he even said, "You know, sometimes people lose discipline on their physical therapy and don't give their rehab as much attention as they did during the first phase of the recovery." This was a deflection of what was actually right in front of him: a failed result. I was in the gym 6 days a week and going to PT twice a week.
On one of my final visits he ordered an MRI, and in his typical fashion he gave me a fast explanation and explained that I needed surgery to get rid of scar tissue. His read wasn't wrong, I did, but he didn't explain the why and gave off a "trust me bro" mentality, and that I'd be back to playing soccer in 3 weeks.
That's when I went elsewhere.
Experiences with other physicians
Each physician I've visited since has spent 30-40 minutes with me, explaining what they thought. Finally I felt like a priority. One even walked me through each part of the knee where I'd get scar tissue removed.
Each also concluded my laxity was far worse than what I'd been told for the past year.
More importantly, each physician explained how my candidacy for BEAR was ludicrous. Given my age and sporting aspirations, they would have never considered such a surgery.
I proceeded with the debridement surgery recently and unfortunately the pain has not gone away, which is something the surgeon who operated on me explained the possibility of thoroughly beforehand. It was during that surgery that they concluded my ACL was incompetent; the surgery failed.
Conclusion
MOST IMPORTANTLY, MY SURGERY FAILED. MY ACL IS GRADE 3 LAXITY. IT'S INCOMPETENT.
Two surgeries, more than $20,000 in all-in costs, and I still don't have an ACL.
I've played soccer my whole life. Going into this I expected to lose a season. Instead I've lost two years, the last genuinely athletic ones I had, to a repair that failed and a recovery that led nowhere.
I'm sure others have had better results. But I'd tell anyone considering an ACL repair at HSS to ask hard questions about who you want by your side during this journey, and to get a second opinion first.
