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Updated: Aug 6, 2026
Surgical Retrieval, Isolation and In vitro Expansion of Human Anterior Cruciate Ligament-derived Cells for Tissue Engineering Applications
Published on: April 30, 2014
Public interest in anterior cruciate ligament reconstruction, repair, and bridge-enhanced repair: A 20-year
Shankar S Thiru1, Kory B D Pasko1, Dean Wang1
1Department of Orthopaedic Surgery, UC Irvine, USA.
Background:
Public interest in anterior cruciate ligament (ACL) surgery has evolved with the emergence of repair techniques and technologies such as the bridge-enhanced ACL repair (BEAR) implant. Therefore, the purpose of this study was to evaluate 20-year trends in public interest in ACL reconstruction, ACL repair, and the BEAR implant and to assess temporal changes, academic-public coupling, and projected future search behavior.
Methods:
Google Trends was queried for the terms "ACL reconstruction," "ACL repair," "BEAR implant," and "internal brace ACL" from January 2004 through March 2026 (the US and worldwide). Monthly relative search volume (RSV) was extracted. Compound annual growth rates (CAGR) and era comparisons (2014-2018 vs 2019-present) were calculated. Interrupted time-series (ITS) analysis assessed level and slope changes at four prespecified milestones, including the COVID-19 disruption, the BEAR Food and Drug Administration (FDA) De Novo clearance, and the publication of the BEAR randomized controlled trial. Spearman correlation evaluated associations between annual PubMed publication counts and RSV. Prewhitened cross-correlation assessed temporal relationships between the terms. Autoregressive models forecasted trends through December 2028.
Results:
"ACL reconstruction" had the highest mean RSV (US, 29.9) but a declining CAGR of -1.7%/year (95% confidence interval [CI]: -2.0%, -1.4%). "ACL repair" and "BEAR implant" showed positive growth of +4.7% (95% CI: 3.4%, 5.9%) and +14.1% (95% CI: 12.9%, 15.4%) per year. ITS analysis at the BEAR FDA De Novo clearance (December 2020) showed a statistically significant postmilestone slope acceleration for "ACL repair" (+0.23 RSV/mo, p < 0.001); "BEAR implant" did not accelerate beyond its pre-existing trend. Exploratory autoregressive integrated moving average (ARIMA) forecasts suggest that "ACL repair" RSV may approach that of "ACL reconstruction" levels by 2028.
Conclusion:
Over 20 years, public search interest has shifted from ACL reconstruction toward repair-oriented approaches. As these queries continue to rise, surgeons should anticipate more patient inquiries about ACL repair and augmentation, necessitating proactive clinical awareness and evidence-based resources to guide shared decision-making.
Level Of Evidence:
IV; Retrospective Infodemiologic Time-Series Analysis.