Eighty-three patients undergoing ACL reconstruction with bone-tendon-bone allograft were randomized to receive either intra-graft BMAC (n=44) or no BMAC (n=39). The primary outcomes of interest were Tegner activity scores and IKDC scores at 9 months. Secondary outcomes included MRI-based signal intensity ratio (SIR) and graft volume. Outcomes were assessed at 3 and 9 months. Overall, the results of the study revealed no difference in Tegner or IKDC scores when all patients were considered. However, among patients with concurrent meniscus or cartilage pathology, the BMAC group had significantly higher IKDC scores at 9 months and significantly higher SIR at 3 months. These findings suggest that BMAC may enhance functional recovery in patients with additional intra-articular pathology.