CHONDROCYTE TRANSPLANTATION - EXPERIMENTAL AND CLINICAL-APPLICATION

Transplantation of autologous chondrocytes proliferated in vitro to tr eat cartilage defects is discussed controversially, Cartilage has only a very limited capacity to regenerate. The repair tissue is of minor biomechanical stability and therefore induces degenerative arthritis o f joints in the long term. Facial cartilage defects may lead to aesthe tic or functional problems. Different biological and synthetic substit utes were used to treat cartilage defects in orthopaedic and facial pl astic surgery. Biological tissue for transplantation is not abundant a nd synthetic materials may induce foreign body reactions. Amplificatio n of autologous cells in vitro to produce a tissue similar to the impa ired tissue seems tempting. It is transplantable into the defect and i s ought to restore the defective surface completely. This is the inten tion of numerous scientific investigations concerning chondrocyte appl ication to cartilage defects. Transplantation of isolated chondrocytes is currently used in clinical trials also. The possibilities and limi tations of this technique are discussed including the fundamental prin ciples and our own experimental investigations. A proof for the reprod uction of a tissue similar to native cartilage with its typical long t erm mechanical properties is still missing. Further laboratory and cli nical studies should be conducted before the technique is propagated i n patient care.