The population of patients with early arthritis remains a treatment challenge because of the specifics of their disease (diffuse chondrosis rather than focal defect, frequent associated morbidities such as instability or meniscal deficiency) and where they are in life (young, active, working). Too young with "not enough damage" for arthroplasty but frequently unresponsive to conservative care, they are in the midst of life yet functionally quite limited. The next generation of non-arthroplasty implants is being investigated to potentially bridge this treatment gap and provide relief for the ever-growing number of young patients with arthritis.