Autologous chondrocyte transplantation (ACT) provides durable hyaline repai
r tissue in correctly selected patients; it is indicated for full thickness
, weightbearing condyle injuries, and injuries to the trochlea of the femur
. ACT results in reproducibly satisfactory results, with return to high lev
el activities, including sports, in over 90% of these patients. Second look
arthroscopies demonstrate macroscopic integrity of the grafts; and biopsie
s demonstrate hyaline cartilage repair, which is critical, as shown clinica
lly, to giving durable results at two to nine years follow-up. Also discuss
ed in this article is surgical technique which is especially important for
complex reconstructions. As technical refinements and rehabilitation protoc
ols improve, results for treating patellar and tibial injuries may improve;
at this time, the response to treating bipolar focal chondral injuries is
unknown and not recommended.