ACI efficacy has yet to be proved better for knee osteochondral lesions than other procedures efficacies. In the short term (2-3 years), ACI and MACI patients’ knee conditions improve. ACI is a safe procedure. Nevertheless, the new variant (MACI) could be safer since it presents fewer hypertrophy-related adverse events. The effectiveness of ACI and MACI has to be proved through randomized clinical trials, for both knee and ankle joints. Patients with associated joint diseases have to undergone correction of those in conjunction with ACI.