The clinical consequences of articular cartilage defects of the knee are pain, swelling, mechanical symptoms, athletic and functional disability, and osteoarthritis. Full thickness articular cartilage defects have a poor capacity to heal. The challenge to restore the articular cartilage surface is multidimensional, faced by basic scientists in the laboratory and orthopedic surgeons in the operating room. This article provides an overview of the contemporary treatment options available for the restoration of articular cartilage defects of the knee.