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Articular cartilage injury and degeneration occurs frequently in athletes and results from the significant chronic joint stress and acute traumatic injuries associated with high-impact sports. These injuries do not heal spontaneously and often lead to progressive painful impairment of joint function and limitation of sports participation. Untreated articular cartilage defects frequently lead to chronic joint degeneration and disability. Treatment of articular cartilage injury in athletes can be complex and requires effective and durable joint surface restoration that can withstand even the significant joint stresses generated during sports activity. Several established articular cartilage repair techniques have been shown to successfully return the athlete with articular cartilage injury to high-impact sports. In addition, novel treatment concepts and techniques that apply modern tissue engineering technologies promise further advancement in the treatment of these challenging injuries in the demanding athletic population.