51 articles (3 RCTs, 10 comparative studies, 33 case series, and 5 case reports) were analyzed to evaluate the current literature on matrix-assisted autologous chondrocyte (MACT) transplantation for treatment of chondral and osteochondral lesions of the knee, with the aim of providing conclusive evidence on the benefits of MACT. This systematic review examined results from each article involving different procedures of MACT treatment and indicated that the treatments offered positive outcome over time for specific patient categories. However this analysis was based on studies of variable quality and therefore high-level long term studies are required to further validate the recommendation of MACT of chondral and osteochondral lesions of the knee.