{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:17:35Z","timestamp":1790572655505,"version":"4.1.0"},"reference-count":149,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Focal chondral defects of the knee are a common cause of pain and functional limitation in active individuals and may predispose to early degenerative joint changes. Given the limited regenerative capacity of hyaline cartilage, biologically based surgical strategies have emerged to promote tissue repair and restore joint function. This narrative review critically examines current treatment approaches that rely on autologous cell sources and scaffold-supported regeneration. Particular emphasis is placed on techniques that stimulate endogenous repair or support chondrocyte-based tissue restoration through the use of autologous biomaterial constructs. The influence of lesion morphology, joint biomechanics, and patient-specific variables on treatment selection is discussed in detail, focusing on the differences between tibiofemoral and patellofemoral involvement. Biologically driven approaches have shown promising mid- to long-term outcomes in selected patients, and are increasingly favoured over traditional methods in specific clinical scenarios. However, the literature remains limited by heterogeneity in study design, follow-up duration, and outcome measures. This review aims to provide an evidence-based, morphology-informed framework to support the clinical decision-making process in the management of knee cartilage defects.<\/jats:p>","DOI":"10.3390\/cells14151217","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:25:52Z","timestamp":1754558752000},"page":"1217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Regenerative Cartilage Treatment for Focal Chondral Defects in the Knee: Focus on Marrow-Stimulating and Cell-Based Scaffold Approaches"],"prefix":"10.3390","volume":"14","author":[{"given":"Filippo","family":"Migliorini","sequence":"first","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany"},{"name":"Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), via Lorenz B\u00f6hler 5, 39100 Bolzano, Italy"},{"name":"Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di San Pio V, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Simeone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), via Lorenz B\u00f6hler 5, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0169-8326","authenticated-orcid":false,"given":"Tommaso","family":"Bardazzi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), via Lorenz B\u00f6hler 5, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Kurt","family":"Memminger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), via Lorenz B\u00f6hler 5, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1096-8467","authenticated-orcid":false,"given":"Gennaro","family":"Pipino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Villa Erbosa, IRCCS Ospedale S. Raffaele, 40119 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-9533","authenticated-orcid":false,"given":"Raju","family":"Vaishya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110076, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5327-3702","authenticated-orcid":false,"given":"Nicola","family":"Maffulli","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University \u201cLa Sapienza\u201d of Rome, Via di Grottarossa 1035, 00189 Roma, Italy"},{"name":"School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke-on-Trent ST4 7QB, UK"},{"name":"Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1080\/02841850500335127","article-title":"Experimental autologous osteochondral plug transfer in the treatment of focal chondral defects: Magnetic resonance imaging signs of technical success in sheep","volume":"46","author":"Uhl","year":"2005","journal-title":"Acta Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"898","DOI":"10.3928\/01477447-20061001-17","article-title":"What\u2019s new in the treatment of focal chondral defects of the knee?","volume":"29","author":"Lattermann","year":"2006","journal-title":"Orthopedics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2325967118801931","DOI":"10.1177\/2325967118801931","article-title":"Do Focal Chondral Defects of the Knee Increase the Risk for Progression to Osteoarthritis? 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