Chondral injuries present us with one of the most challenging conditions in orthopaedics today. The problem being that this chondral cartilage has a poor inherent capacity to heal. Therefore, once damaged, problems of pain, stiffness, swelling and functional restrictions can develop. The extent of the damage and level of symptoms will determine then what options are available. Many can simply just be observed and monitored whilst others cause enough restriction that surgery needs to be considered. The surgical options can be complex and most need prolonged recovery times. The surgical options that might be discussed at consultation include: injections, chondroplasty, microfracture, osteochondral autograft transplantation (OATS), and occasionally more end-stage major options such as osteotomy and arthroplasty (a joint replacement).