UNLABELLED: Matrix-induced autologous chondrocyte implantation (MACI) is a viable procedure that can be used as both a primary or revision cartilage regenerative procedure in high-functioning individuals without tibiotalar arthritis. Both short-term and midterm follow-up results demonstrate clinical, radiographic, and functional improvements with high rates of return to full activities. Cost remains a chief concern with the use of this technique, but theoretical improvements in the durability of repair with type II cartilage replacement may offer long-term benefits. LEVEL OF EVIDENCE: Level V, expert opinion.