Surface-based procedures that avoid subchondral bone penetration have the potential to allow resumption of sports-specific training at earlier time points than many of the current options for International Cartilage Repair Society (ICRS) 4A lesions. These viable chondral allografts can be used to treat cartilage lesions in other joints such as the elbow, shoulder, and ankle as well. Further comparative studies and longer follow-up can help delineate the best patients for these surface-based cartilage treatment options.