The structure and biomechanical forces on the patellar joint challenges researchers to define an ideal method for resurfacing the patellar cartilage. The articular surface of the patella presents variability between individuals, and has various minor articulations that bear partial or total compressive, shear, and combined forces during movement. Surgical techniques for the repair of patellar cartilage defects have evolved from cumulative advances in basic science and technology. Such surgeries include the techniques that promote either fibrocartilage formation or hyalinelike cartilage formation. Techniques promoting the formation of fibrocartilage yield shortterm solutions because fibrocartilage lacks the durability and the mechanical properties of articular hyaline cartilage. Currently, there is no ideal method for the repair of patellar cartilage defects; all methods are considered experimental. Additional controlled and randomized clinical studies with large series of patients and long-term followup are required.