Articular cartilage injury can be associated with great disability and functional decline. There have been advancements in cartilage repair techniques capable of restoring durable hyaline-like cartilage, even in cases of large or multiple lesions. Single-stage surgical treatments that minimize patient morbidity and provide socioeconomic benefit are ideal. Cartilage repair using a hyaluronic acid-based scaffold combined with bone marrow aspirate containing mesenchymal stem cells (HA-BMAC) has demonstrated successful long-term clinical outcomes for a wide range of patient ages, and when used to treat multiple large articular cartilage defects. Furthermore, recent developments in computer-assisted design of patient-specific instruments and implants to facilitate procedures such as osteotomy and meniscal allograft transplantation improve safety and precision when more complex joint preservation surgery is indicated.