Advanced techniques in autologous chondrocyte transplantation.

Autologous chondrocyte transplantation (ACT) provides durable hyaline repair 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 level activities, including sports, in over 90% of these patients. Second look arthroscopies demonstrate macroscopic integrity of the grafts; and biopsies demonstrate hyaline cartilage repair, which is critical, as shown clinically, to giving durable results at two to nine years follow-up. Also discussed in this article is surgical technique which is especially important for complex reconstructions. As technical refinements and rehabilitation protocols 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.