Background: Anterior Cruciate Ligament (ACL) ruptures are integral contributors to all ligamentous knee injuries. The primary management is anterior cruciate ligament reconstruction (ACLR). Despite a high success rate, significant efforts are dedicated to improving healing, functional outcomes, and minimizing complications, including biological augmentation. This scoping review aims to collect, summarize, and investigate the biological modalities commonly utilized as the adjuvant therapy after ACLR.

Methodology: A comprehensive search was conducted for this review in the following databases: Pubmed, Cochrane, and Sciencedirect. The inclusion criteria were all individuals who received ACLR with intraarticular injection of biological augmentation postoperatively. Only articles published between 2016 and 2025 were retained. Injection of PRP, hyaluronic acid and stem cells were included. Reviews and non-original studies were excluded.

Results: Nine studies were selected for review and a descriptive analysis was performed. The most common injection was platelet rich plasma (PRP). The presented data highlighted a lack of consensus regarding the positive impact of adjuvant therapy within existing studies, as determined by the identification of graft maturation and knee functional performance. While the long-term benefits of this method require further study, the short-term effects (such as enhance graft healing, reduce inflammation, and support early functional recovery, and better VAS score) could be assessed comparatively, thus clarifying substance selection.

Conclusion: Despite the favorable safety and efficacy outcomes regarding biological augmentation via intra-articular injection post-ACLR, significant long-term effects failed to demonstrate benefit. Moreover, short-term advantages may vary for each substance. Therefore, further research is vital to unravel the augmentation with the most benefit after ACLR.