We examined 28 young athletes with isolated severe chondral damage in the weight-bearing area of the knee joint clinically and radiographically 14 years after arthroscopic diagnosis. Except for Pridie drilling in 3 cases and occasional cartilage shaving or removal of free bodies, no special treatment was given initially. 21 patients were able to return to preinjury team sport activity levels. During the follow-up period, only 3 patients needed repeat surgery with removal of free bodies, and another 2 underwent diagnostic arthroscopy because of persistent pain. At the latest follow-up evaluation, 22 patients had excellent or good knee function. At this time, the patients were mainly involved in individual sports on a physical fitness level. 12 cases had radiographic joint space reduction (< 50%) which was limited to the compartment concerned.