Osteochondral defect (OCD) represent a prevalent orthopedic condition that significantly impacts patients' quality of life due to the complex anatomical structure and poor intrinsic healing capacity of the affected tissue. While current treatment modalities (including arthroscopic surgery, microfracture, osteochondral autograft/allograft transplantation, and regenerative therapies) demonstrate varying efficacy, all present inherent limitations. To address this challenging clinical problem and achieve complete regeneration of the osteochondral unit, a novel biphasic, porous, biocompatible and biodegradable aragonite-based scaffold—Agili-C^®—has emerged as a promising solution.This review examines the anatomical characteristics of OCD and elucidates the microstructure of Agili-C^® along with its mechanism for OCD repair. We evaluate preclinical and clinical studies, detail its indications and surgical techniques, aiming to provide both theoretical foundation and practical guidance for Agili-C^® application in knee OCD management. Furthermore, this article critically addresses limitations identified in previous clinical trials and emphasizes the need for ongoing assessment of long-term therapeutic outcomes.