2026 AOSSM Annual Meeting: Effects of Platelet-Rich Plasma and Bone Marrow Aspirate on Knee Kinematics, Graft Elongation and Muscle Function After ACL Reconstruction

43 patients undergoing unilateral anatomic bone–patellar tendon–bone anterior cruciate ligament reconstruction (ACLR) were randomized to receive platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), or no orthobiologic treatment. The outcomes of interest were knee kinematics, anterior cruciate ligament (ACL) graft elongation and strain, and muscle function. Additional outcomes included ground reaction forces, side-to-side strength asymmetry, and relationships between muscle-strength deficits and altered knee mechanics. Outcomes were assessed at six and 12 months after surgery. Overall, the results revealed that PRP and BMAC were associated with better extension strength symmetry, greater reconstructed-limb loading, and higher graft strain at six months, without meaningful differences between the two orthobiologic treatments. These between-group differences largely resolved by 12 months, when persistent quadriceps weakness was strongly associated with altered sagittal-plane knee mechanics. The findings suggest that PRP and BMAC may accelerate early functional recovery, while targeted quadriceps rehabilitation remains important for restoring knee mechanics.