Knee preservation surgery has evolved significantly with the introduction of advanced techniques aimed at restoring joint surface integrity, relieving pain, and promoting functional recovery. As the treatment strategies continue to shift, it is imperative for cartilage surgeons to remain informed about the expanding array of surgical options. In addition to cartilage restoration, there is growing interest in meniscal preservation using synthetic implants and scaffold-based approaches. These emerging technologies must be rigorously assessed for safety, efficacy, and long-term outcomes prior to broader adoption. A thorough understanding of these innovations is critical as the field moves toward more personalized, biologically driven solutions for joint preservation.