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Virtua Orthopedics & Spine Doctor Helps MMA Fighter to Fight Again

Ryan Cafaro, Mixed Martial Arts (MMA) fighter and coach, 33, from Pennsauken, NJ, is considered a top prospect in the world of Mixed Martial Arts. When Ryan tore his ACL in March 2022, he knew he needed to find the best way to treat the injury, get his fighting career back on track, and achieve his goal for himself—to fight again within a year of his injury. Ryan’s first fight is scheduled for March 31, 2023. 

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Sean McMillan, DO, sports medicine surgeon at Virtua Orthopedics & Spine, is the first surgeon in New Jersey to perform the Bridge-Enhanced ACL Repair (BEAR®) Implant procedure. Dr. McMillan is the lead Virtua Health physician overseeing the BEAR III clinical trial. Dr. McMillan performed the procedure on Ryan as a clinical trial participant in April 2022.  

The BEAR Implant is the first medical implant to enable the body to heal its own torn anterior cruciate ligament (ACL). This ACL restoration is a paradigm shift from the current standard of care – reconstruction that replaces the ACL with a graft – and is considered to be the first innovation in ACL tear treatment in more than 30 years. The BEAR Implant was approved by the U.S. Food and Drug Administration in December 2020, and Virtua is one of 10 sites in the U.S. participating in the BEAR® III label-expansion study. Virtual ranks third in the number of patients treated in the trial.  

Approximately 400,000 ACL injuries occur annually in the U.S., making it one of the most common knee injuries. A torn ACL does not have the ability to heal on its own, so ACL tears are often treated with surgery called ACL reconstruction, in which a surgeon completely removes the remaining torn ACL and reconstructs it with either a tendon from the patient’s own leg (called an autograft) or that of a deceased donor (called an allograft). The BEAR Implant does not require a second surgical wound site to remove a healthy tendon from another part of the leg or the use of a donor tendon.

 Instead, the BEAR Implant acts as a bridge between the two ends of the torn ACL. The surgeon injects a small amount of the patient’s own blood into the implant and inserts it between the torn ends of the ACL in a minimally invasive procedure. The combination of the BEAR Implant and the patient’s blood enables the body to heal the torn ends of the ACL back together. As the ACL heals, the BEAR Implant is absorbed by the body, within approximately eight weeks. Return to high levels of activity and sports is usually around nine months after surgery, which is similar to ACL reconstruction. 


“There are a number of advantages to restoring a ligament instead of replacing it, and this exciting medical technology is the first to clinically demonstrate that it enables healing of the patient’s torn ACL while maintaining the natural knee anatomy,” said Dr. McMillan. “Encouraging clinical studies have shown faster recovery of muscle strength and higher patient satisfaction with regard to readiness to return to sport than traditional ACL reconstruction, which makes the BEAR Implant especially ideal for athletes like Ryan. Also, early data has shown the potential for decreased arthritis in the long-term with the BEAR Implant which is important for all patients.” 

After researching the procedure and meeting with Dr. McMillan, Cafaro applied to participate in the current BEAR III clinical trial and was “ecstatic” to learn he was accepted into the trial. “I extensively researched my options and realized the BEAR Implant would allow my body to repair my own tissue and give my knee a second life,” he explained. “I plan on fighting and coaching for a long time, and I didn’t want to worry about a second incision or donor grafts or arthritis later in life.” 


It has been ten months since Cafaro had BEAR Implant restoration surgery and on March 31, 2023, he will achieve his goal of fighting again within a year of his ACL injury.   


“I was very disciplined and focused during my rehabilitation, knowing that I need to perform as an elite-level athlete,” he explained. “I did something every day to ensure that I was making progress on my recovery, which included physical therapy, strength training and conditioning, and nutrition. I am rigorously training two or three times a day, six days a week. My knee feels great, and I know it can withstand what is coming in the ring. I truly believe the BEAR Implant restoration was my best choice.”   

About Virtua Health:
 Virtua Health is an academic health system committed to helping the people of South Jersey be well, get well, and stay well by providing the complete spectrum of advanced, accessible, and trusted healthcare services. Virtua’s 14,000 colleagues provide tertiary care, including renowned cardiology and transplant programs, complemented by a community-based care portfolio. In addition to five hospitals, two satellite emergency departments, 34 ambulatory surgery centers, and more than 350 other locations, Virtua brings health services directly into communities through Hospital at Home, physical therapy and rehabilitation, mobile screenings, and its paramedic program. Virtua has 2,850 affiliated doctors and other clinicians, and its specialties include orthopedics, advanced surgery, and maternity. Virtua is academically affiliated with Rowan University, leading research, innovation, and immersive education at the Virtua Health College of Medicine & Life Sciences of Rowan University. Virtua is also affiliated with Penn Medicine for cancer and neuroscience and the Children’s Hospital of Philadelphia for pediatrics. As a not-for-profit, Virtua is committed to the community's well-being and provides innovative outreach programs that address social challenges affecting health, most notably the “Eat Well” food access initiative, which includes the unparalleled Eat Well Mobile Grocery Store. A Magnet-recognized health system ranked by U.S. News and World Report, Virtua has received many awards for quality, safety, and its outstanding work environment. For more information, visit To help Virtua make a difference, visit