Kissing surface type defects of the cartilage represent a special category in cartilage diseases. They are characteristics for more difficult treatment, more compromises and moderate results. The authors adopted mosaicplasty technique for full thickness cartilage defects. According to their early experiences, this technique can provide capable healing type resurfacement and quick rehabilitation. There is a separate injury on cartilage surface, so called "kissing surface" injury (patellofemoral injury on both surfaces at the same time). The treatment possibility is much more difficult, more compromising and the results are moderate. Mosaicplasty was the choice of treatment by authors. This method provides better results than other methods, mainly because of the high quality and better rehabilitation.