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Background: Combining arthroscopic microfractures (MF) with platelet-rich plasma (PRP) complexes is a potential approach for treating knee cartilage injuries. However, effective treatment of cartilage injuries in the knee joint remains a challenge. Objective: To evaluate the clinical effects of a platelet-rich complex based on MF surgery for treating knee cartilage injuries. Methods: We selected 120 patients with knee cartilage injury and divided them into observation and experimental groups according to the use of a platelet-rich complex. Preoperative and postoperative follow-up visit data were retrospectively collected and analyzed. Results: Preoperative visual acuity scores between the two groups were comparable ($P>0.05$). At 3 and 6 months postoperatively, the scores were lower in the experimental group than in the control group ($P<0.05$). The preoperative Lysholm knee scores and Tegner activity were similar ($P>0.05$) but greater in the experimental group at 3 and 6 months postoperatively ($P<0.05$). Postoperative complications were similar between the two groups according to Fisher’s exact test ($P=1.00$). Conclusion: The platelet-rich complex based on MF surgery treatment of knee cartilage injuries exhibited a better clinical effect and is an easy-to-operate and effective method worthy of clinical consideration.