The treatment of femoral cartilage lesions still remains a challenge. Established cartilage repair techniques include microfracture (MFX), acellular scaffolds and cell based therapies such as ACI and MACI, which differ in associated morbidity and outcome. Therefore, there have been strong research efforts to develop novel treatment alternatives. In this study, we demonstrate that GelrinC, a novel acellular biodegradable implant, allows a successful treatment of both chondral and osteochondral femoral lesions in a minimal invasive one-step procedure. For both lesion types a substantial improvement of MOCART scores as well as T2 values has been demonstrated over a 24-month period.