Tissue engineering offers the possibility to fabricate living substitutes f
or tissues and organs by combining histogenic cells and biocompatible carri
er materials. Pluripotent mesenchymal stem cells are isolated and subcultur
ed ex vivo and then their histogenic differentiation is induced by external
factors. The fabrication of bone and cartilage constructs, their combinati
ons and gene therapeutic approaches are demonstrated. Advantages and disadv
antages of these methods are described by in vitro and in vitro testing. Th
e proof of histotypical function after implantation in vivo is essential. T
he use of autologous cells and tissue engineering methods offers the possib
ility to overcome the disadvantages of classical tissue reconstruction - do
nor site morbidity of autologous grafts, immunogenicity of allogenic grafts
and loosening of alloplastic implants. Furthermore, tissue engineering wid
ens the spectrum of surgical indications in bone and cartilage reconstructi
on.