Chondral defects can cause knee pain, swelling, and limited range of motion. In this podcast episode, an orthopedic specialist presents a case study of a 45-year-old patient experiencing knee pain and swelling after an injury. The examination reveals a large effusion and tenderness on the medial side of the knee joint. X-rays show slight narrowing of the medial compartment, indicating potential early osteoarthritic changes. An MRI confirms a full-thickness chondral defect on the medial femoral condyle and a loose body in the knee joint. Treatment options discussed include conservative management with physical therapy, injections, and surgical interventions such as microfracture, osteochondral autograft transfer system (OATS), and matrix-induced autologous chondrocyte implantation (MACI). Successful outcomes depend on proper rehabilitation and weight-bearing restrictions. The patient is considering the best option based on the advantages and disadvantages of each procedure.