The BEAR Procedure: A Revolutionary Approach to ACL Repair

ACL tears are one of the most common knee injuries, sidelining more than 100,000 Americans every year. Traditionally, repairing a torn ACL (Anterior Cruciate Ligament) required surgical reconstruction using tissue from another part of the patient’s body or donor tissue. While often effective, this procedure is invasive and requires a lengthy recovery time. But now, thanks to advancements in orthopedic surgery, patients suffering from a torn ACL have an alternative called Bridge Enhanced ACL Restoration, also known as BEAR.

What is the BEAR Procedure?

BEAR is a breakthrough in ACL repair that enables the body to naturally heal on its own. Because synovial fluid, which reduces friction in the knee, prevents formation of blood clots that are necessary for healing, the ACL does not have the ability to heal itself. In the BEAR procedure, instead of removing the damaged ACL and replacing it with donor tissue, a special implant is used to bridge the torn ends of the ligament. This creates an ideal healing environment, enabling the ACL to heal, typically within eight weeks.

Meet Dr. Welch: Maine’s First BEAR Surgeon

At Atlantic Orthopaedics & Sports Medicine, we’re proud to have Dr. Welch, a pioneer in ACL repair, on our team. Dr. Welch was the first surgeon in Maine to perform the BEAR procedure and remains one of the few specialists in the region to offer it. He performs the surgery at York Hospital and at the New England Center for Orthopedic Surgery in Portsmouth, providing patients with a cutting-edge alternative to traditional ACL reconstruction.

Why Choose the BEAR Procedure?

For many patients, BEAR offers significant advantages over traditional ACL surgery:

Preserves your own tissue: unlike reconstruction, which requires a graft from another part of the body or a donor, BEAR allows your ACL to heal naturally.

Better post-operative knee function: because the original ACL is preserved, patients tend to experience less pain and less muscle weakness after surgery.

Less invasive: the surgery is an outpatient procedure, and does not require harvesting tissue from another part of the body

No donor tissue risks: There’s no concern over donor graft quality

Faster healing timeline

Real Results: A Patient’s Journey Back to Running

Patients who undergo the BEAR procedure are seeing amazing outcomes, including Rachel, who recently shared her experience:

“Thanks to Dr. Welch at Atlantic Orthopaedics & Sports Medicine for the amazing BEAR procedure and Shantelle and Ian at Coppola Physical Therapy for helping me get back on the road as quickly as I did. I’m so lucky to have this team and my family and friends cheering me on.”

Six months after her surgery, Rachel was back to running–something that once felt impossible. Her success story is just one of many that demonstrate the life-changing potential of this innovative ACL repair method.

Who is Eligible for BEAR?

The BEAR implant was cleared by the FDA for patients who meet the following criteria:

Must be at least 14 years old.
Must have a complete ACL rupture, as confirmed by MRI.
Must have an ACL stump attached to the tibia.

The team at Atlantic Orthopaedics & Sports Medicine are committed to bringing the latest advancements in orthopedic care to our patients. Dr. Welch continues to be at the forefront of ACL treatment, helping patients regain knee strength and mobility with a less invasive approach than traditional reconstruction. If you’ve suffered an ACL tear and are exploring your options, the BEAR procedure may be the right choice for you. Contact Atlantic Orthopaedics today to schedule a consultation with Dr. Welch and learn more.

One & One with Dr. Welch & Ryan LaBelle, PA: Common Knee Injuries & Treatments

Relief From Hip Pain – How Arthroscopy Can Alleviate Pain and Restore Function

Hip pain can be debilitating, affecting everything from mobility to sleep to overall quality of life. The hip joint is where the thigh bone (femur) connects to the pelvis and is used constantly when one walks, bends, and supports his/her upper body.

Who is a good candidate for Hip Arthroscopy?

Hip pain has varied causes; in young people the most common cause is a labral tear–damage to the soft tissue lining the inside of the hip socket (acetabulum). A Labral tear can occur from repetitive wear over time, impingement from an underlying problem with the joint structure, or trauma from a sports injury or accident.

For patients who suffer from a labral tear –and who have not found relief from conservative treatments like rest, over-the-counter pain relievers and physical therapy–hip arthroscopy may be the answer. It’s a minimally invasive procedure that can restore hip function and alleviate pain.

Patients with osteoarthritis, cysts, or ankylosis (fusion) of the hip joint are not good candidates for hip arthroscopy.

What is involved in the Hip Arthroscopy procedure?

First, an orthopedic specialist will determine whether hip arthroscopy is appropriate based on a physical exam and x-ray or MRI imaging. Unlike open surgery, arthroscopy only requires a small incision through which a camera (arthroscope) is inserted. This gives the surgeon a clear, magnified view of the interior of the hip joint during the procedure. The surgeon will then repair or remove the damaged labrum, bone impingement, or loose bodies. Performed in an outpatient setting , arthroscopic hip surgery usually leads to less post-operative pain and shorter recovery time than open hip surgery.

Surgical Expertise + State of the Art Technology

Dr. Tyler Welch is a board certified orthopedic surgeon who has performed approximately 300 hip arthroscopy procedures – In addition to his extensive experience, Dr. Welch utilizes state-of-the-art technology, including “HipMap” software that generates a detailed 3D image of the hip structure in advance of the procedure. Used as a planning tool, this advanced imaging enables him to precisely target the surgery and minimize disruption to surrounding tissue.

Another innovative device employed by Dr. Welch is the Guardian, a cutting-edge operating table designed to hold the patient comfortably and securely in place, while providing the surgeon greater range of motion and visibility during the procedure. Traditionally, achieving proper positioning for hip surgery required the use of a post between the patient’s legs, a technique that can cause groin pain . The Guardian table has eliminated post-operative groin pain.

Below, we asked Dr. Welch a few questions about hip arthroscopy.

Where do you perform this procedure?
I perform hip arthroscopy at NECOS and at York Hospital.

Are you still the only practice in the Seacoast that uses the Guardian Table for this procedure?
That’s right, I’m still the only surgeon on the Seacoast that uses the Guardian Table.

Anything else you’d like current or future patients to know about this procedure and how it would benefit them?
What is nice about hip arthroscopy is that it is a relatively straightforward recovery. Crutches are only required for about one week, and most patients make significant gains within 4-6 weeks. It is not too painful, and I have found that most patients only require pain medication for the first 24-48 hours.

Also, surgery is reliable for the right patient. As long as the patient has hip impingement without any sign of arthritis, surgery typically alleviates pain and eliminates most symptoms.

If you suffer from hip pain, don’t ignore it. Atlantic Orthopaedics and Sports Medicine offers treatments–both surgical and non-surgical–that can alleviate hip pain and restore your quality of life. If you think that hip arthroscopy may be right for you, schedule a consultation with Dr. Welch to learn more.

Torn Meniscus? Eliminate Knee Pain With This Procedure

The meniscus is a C-shaped piece of cartilage in the knee joint that plays a crucial role in function and stability. The two meniscii in each knee function as shock absorbers. They are composed of dense fibrocartilage, which is more flexible than bone but firmer than other types of cartilage. Meniscus pads play an important role in walking, running and jumping, and they aid in weight distribution and alignment. The meniscus also helps keep the knee joint lubricated to reduce friction between the femur (thigh bone) and tibia (shin bone).

A meniscus root tear is a relatively common knee injury that occurs when the meniscus separates from its attachment point on the tibia bone. This type of tear can be caused by the wear and tear that happens with age, or by trauma or injury, such as a sports injury. People who suffer a tear often feel a “popping” sensation in the back of the knee, followed by pain, instability, and a loss of function. Untreated, a meniscus root tear can lead to osteoarthritis and degeneration in the knee. Fortunately, there is a minimally invasive procedure available to fix the issue.

Atlantic Orthopaedics’ surgeon Dr. Welch specializes in meniscus root repair, having performed more than 100 successful procedures to restore function, eliminate pain, and prevent further damage. In this surgery, he makes three small incisions, prepares the torn end of the meniscus for repair, then securely reattaches the meniscus to the root attachment site on the tibia bone through a small tunnel in the tibia.

Following surgery, Dr. Welch places the patient’s knee in a brace to protect the repaired meniscus and allow it to heal. Physical therapy is an important part of the recovery process. Recovery from meniscus root repair takes time and it’s important to follow your surgeon’s instructions regarding weight-bearing and the use of crutches. It may take three months for the knee to fully heal, but the vast majority of patients have excellent outcomes and experience a return to normal knee function.

Below, Dr. Welch answers some questions about Meniscus Root Repair:

Q. In your own words, how does this procedure benefit your patients suffering from knee pain?

A. A meniscus root tear is a specific type of meniscus tear that is more serious than a typical meniscus tear. If the root tears, the meniscus becomes loose and unstable. Surgery involves repairing the meniscus back to the tibia bone. This procedure benefits patients because it restores the function of the meniscus, eliminates pain, and helps restore patient confidence in his/her knee.

Q. Who is a good candidate for a Meniscus Root Repair?

A. A proper candidate for meniscus root repair is a patient who sustains a root tear who does not have significant arthritis in the knee.

Q. Where do you perform Meniscus Root Repairs ?

A. I perform meniscus root repairs at New England Center for Orthopedic Surgery (NECOS) in Portsmouth, NH and at York Hospital in York, ME.

Q. Do you have a recent patient success story you can share?

A. I have dozens of patient success stories. Meniscus root repairs are very reliable; as long as the meniscus heals to the tibia, patients usually return to normal function with no issues. Previous studies have revealed success rates > 90%.

Q. Anything else you’d like patients to know about this procedure?

A. I have many patients (>100) who have had tremendous success after a meniscus root repair. Unfortunately, one issue with this procedure is that each patient must use crutches or a walker for the first 5-6 weeks after surgery. This is inconvenient, but necessary, so that the meniscus has time to heal.

If you’re suffering from knee pain and loss of mobility from a meniscus root tear, you may be a good candidate for this minimally invasive procedure. Schedule an appointment with Dr. Welch for an evaluation: https://www.atlanticorthopaedics.org/providers/tyler-welch-md/

Atlantic Orthopaedics’ Dr. Tyler Welch Introduces State-of-the-Art Operating Table “The Guardian” at York Hospital

Dr. Tyler Welch was accepted into the International Society for Hip Arthroscopy, and Atlantic Orthopaedics & Sports Medicine will be introducing the hip arthroscopy procedure at York Hospital with a state-of-the-art operating table called the Guardian.

The Pivot Guardian System is a device produced by one of the nation’s lead medical suppliers, Stryker. The Guardian is specifically designed to mitigate complications, as it limits the amount of force applied to a patient’s hip during surgery. The Guardian also enables the surgeon to obtain better visualization of the hip during surgery compared to other operating tables.

The system’s boots enhance patient comfort and safety during surgery, and the surgeon can make precise range of motion adjustments during hip surgery with the Guardian.

The demand for hip arthroscopy is increasing every year, and surgeons in the US are projected to perform 271,000 hip arthroscopy procedures by the year 2021. This will be a compounded annual growth rate of 18.5%, compared to a 3.9% projected growth in shoulder arthroscopy and 1.6% projected growth in knee arthroscopy by the same year.

Atlantic Orthopaedics & Sports Medicine is a leading practice on the Seacoast for orthopaedics and sports medicine. They have offices in Portsmouth, New Hampshire and York, Maine and physicians have full medical staff privileges at both Portsmouth Regional Hospital and York Hospital.

Dr. Welch Publishes Article in Orthopaedic Journal

Portsmouth, NH – Dr. Tyler Welch, a physician at Atlantic Orthopaedics and Sports Medicine, recently published an article in the Journal of Experimental Orthopaedics. It is titled The Effect of a Dynamic PCL Brace on Patellofemoral Compartment Pressures in PCL-and PCL/PLC-Deficient Knees.

The study examines the PCL, or posterior cruciate ligament, located in the back of the knee. One of four major ligaments of the knee, it connects the femur (thighbone) to the tibia (shinbone). In a controlled laboratory study, Dr. Welch and five colleagues explored a deficiency of the PCL leading to arthritis in the patellofemoral knee joint, and evaluated the hypothesis that dynamic bracing reduces pressure in the knee joint in PCL-deficient knees. Coauthors of the study were Thomas Keller, Ruben Maldonado, Melodie Metzger, Karen Mohr and Ronald Kvitne.

The Journal of Experimental Orthopaedics is an international journal that aims to bridge the gap between orthopaedic basic science and clinical medicine, and publishes works that examine the field of experimental orthopaedics. Each published article goes through peer review and is upheld to the high quality standards of the Journal.

Dr. Welch is a physician at Atlantic Orthopaedics who specializes in cartilage restoration, sports medicine, joint replacement, and arthroscopic surgery of the hip, knee and shoulder. He is the lead doctor of the clinic’s Cartilage Center, a place for patients experiencing joint pain and early arthritis. Dr. Welch is affiliated with the American Orthopaedic Society for Sports Medicine, American Academy of Orthopaedic Surgeons, and the Arthroscopy Association of North America.

Atlantic Orthopaedics & Sports Medicine is a group of Board-Certified physicians who utilize the latest concepts in orthopaedics and sports medicine, coupled with preventive and surgical techniques. For more information, visit www.atlanticorthopaedics.org.

Dr. Welch To Present Lecture on Cartilage Restoration Advances

Dr. Tyler Welch of Atlantic Orthopaedics & Sports Medicine is scheduled to present a lecture on Thursday, January 19^th titled Recent Advances in the Treatment of Cartilage Injuries and Early Arthritis: The Future is Here. Open to the general public, the lecture will take place from 6:30-8PM at the Portsmouth Regional Hospital – Hospital Classroom, located on Borthwick Avenue.

Topics of discussion will include: the role of cartilage in joint function, common symptoms in patients with cartilage injuries, the history of cartilage surgery, and the ways in which treatment options have evolved over the last ten to fifteen years in orthopedic medicine. Dr. Welch will also share various cartilage treatment techniques that he currently practices at the Cartilage Center at Atlantic Orthopaedics & Sports Medicine, as well as how location, size, and extent of a cartilage injury’s damage can dictate the appropriate treatment options for a patient.

Dr. Welch is a Board-Certified physician at Atlantic Orthopaedics who specializes in cartilage restoration, sports medicine, joint replacement, and arthroscopic surgery of the hip, knee and shoulder. He is the lead doctor of the clinic’s new Cartilage Center, a place for patients experiencing joint pain and early arthritis. Using cutting-edge treatments in cartilage restoration, Dr. Welch and his team are able to help patients resolve hip, elbow, knee, shoulder and other joint pain, while avoiding more costly and invasive replacement procedures down the road.

His lecture at Portsmouth Regional Hospital is free and open to the general public. To register, please visit portsmouthregionalhospital.com and find the event under “Classes and Events”.

Tyler Paton Welch, MD Joins Atlantic Orthopaedics & Sports Medicine

Atlantic Orthopaedics & Sports Medicine of Portsmouth is pleased to welcome its newest surgeon and health care provider, Dr. Tyler Paton Welch.

Dr. Welch specializes in a wide range of orthopaedic disciplines, including cartilage restoration, arthroscopic surgery of the hip, knee, shoulder and elbow, and joint replacement. By introducing hip arthroscopy to the Seacoast and utilizing the latest techniques in ligament and tendon repair of the knee and shoulder, Dr. Welch brings a unique skill set to Atlantic Orthopaedics & Sports Medicine.

Dr. Welch received his BA from Colgate University in New York and his MD from the University of Connecticut School of Medicine. He completed his residency at Boston University and sports fellowship at Kerlan Jobe Orthopaedic Clinic in Los Angeles, where he was the assistant team physician for the LA Lakers, LA Dodgers, LA Kings, and USC football. His work has been published in multiple journals, including the Journal of Orthopaedic Research. Dr. Welch has also received several grants, including a research grant from the Orthopedic Research & Education Foundation (OREF) and was awarded a Resident Research Award in Orthopaedic Surgery in 2013.

Outside of the office, Dr. Welch enjoys skiing, golf, traveling, and all that the seacoast has to offer.