Knee osteochondritis desiccans, or Koenig's disease, is commonly found in active young people engaged in manual labor, sports etc., i.e. socially active population. Today, we have a good number of surgical method to treatment of this disorder; however, there is still much controversy about their application, and no single approach is considered to be the optimal one. Plus, high-quality biomaterials required for the intervention are sometimes unavailable. The analysis of the results of treatment of patients (spanning several years) proved urgency of the problem and highlighted the necessity to solve a number of related issues. This paper presents the algorithm of surgical treatment of knee osteochondritis desiccans. We have provided surgery validation criteria, suggested optimal methods of correction of local cartilage defects (depending on the degree of damage and patient's age) and outlined some recommendations based on our practical experience.