Does putting PRP in Micro Fracture make better cartilage in patients over 40? Micro fracture is a surgical procedure whereby a hole in the cartilage is treated by poking holes in the bone. The idea is that the bone marrow from the inside of the bone (with stem cells) will leak into the cartilage hole and help it heal with a scar type of cartilage, providing some cushioning for the area. One of the problems with knee micro fracture is that it tends to work best in young athletes and the results fall off precipitously in patients over 40 years old. As a result, some smart surgeons asked themselves if they added platelet rich plasma (concentrated blood platelets that have all sorts of good healing growth factors) would it make micro fracture cartilage any better in older patients? They looked at 49 patients who underwent arthroscopic microfracture for a cartilage lesion (less than 4 cm(2)) with early arthritis aged 40-50 years, were randomly divided into 2 groups: a control group with only arthroscopic microfracture (25 patients) and a study group with arthroscopic microfracture and PRP (24 patients). They performed second look arthroscopies in 10 patients of each group to identify the extent of cartilage restoration at 4-6 months after the surgery. There were significant improvements in clinical results between preoperative evaluation and postoperative at 2 years post surgery in both groups (p = 0.017). Clinical results were significantly better in the study PRP group than in the control group (p = 0.012). In the 2nd look arthroscopies, there was better hardness and elasticity of the repair cartilage in the PRP patients. The upshot? If I was getting micro fracture surgery and was over 40 (which I am), I’d ask the surgeon to throw in some PRP!