This article describes a one-step operative technique for the treatment of circumscript cartilage defects of weight-bearing surfaces of the knee. Since 1992, a total of 227 patients were treated using this technique for full-thickness lesions resulting from chondropathy, traumatic chondral defects, and osteochondritis dissecans; the procedure was evaluated in 57 patients who had > 3 years of follow-up. Magnetic resonance imaging, computed tomography arthrographies, ultrasound, and arthroscopy were used to evaluate the technique. Using the modified Hospital for Special Surgery (HSS) knee scoring system, 91% of the patients achieved a good or excellent result. The operative technique, clinical results, and complications are detailed.