Autologous chondrocytes used for articular cartilage repair - An update

Articular cartilage in adults has a poor ability to self-repair after a sub stantial injury; however, it is not known whether there is a cartilage resu rfacing technique superior to the existing techniques. It is not satisfacto ry that at the beginning of the new millennium, there still is a lack of ra ndomized studies comparing different cartilage repair techniques and there still is little knowledge of the natural course of a cartilaginous lesion. To date, various articular cartilage resurfacing techniques have the potent ial to improve the repair of cartilage defects and reduce the patient's dis ability. One such cartilage repair technique is autologous chondrocyte tran splantation combined with a periosteal graft. Since the first patient was o perated on in 1987, much interest in cartilage repair and cell engineering has emerged. The experience with autologous chondrocyte transplantation dur ing the past 13 years with in vitro chondrocyte expansion, cartilage harves t, and postoperative biopsy technique is discussed, and the latest followup of 213 consecutive patients in different subgroups with 2 to 10 years foll owup is presented. The technique gives stable long-term results with a high percentage of good to excellent results (84%-90%) in patients with differe nt types of single femoral condyle lesions, whereas patients with other typ es of lesions have a lower degree of success (mean, 74%).