Autologous chondrocyte transplantation.

The intrinsic capacity of cartilage to repair chondral injuries is poor. Different techniques to induce cartilage repair with the use of extrinsic chondrogeneic cell sources have been explored in experimental models. Cells can be harvested autologously or as allografts from a healthy part of the donor tissue, isolated, expanded in vitro, and finally implanted into the defect in high densities. Pure chondrocytes, epiphyseal or mature, allogeneic or autologous, and other types of mesenchymal cells have been used. The composition and structure of the extracellular cartilage matrix are maintained through a balance of anabolic and catabolic activities controlled by the unique chondrocytes. They keep the cartilage alive; they alone maintain it and regulate it. It therefore seems important to use true committed chondrocytes to repair a local cartilaginous defect. The rational basis for the use of committed autologous chondrocytes in combination with a covering periosteal membrane in the treatment of deep cartilage defects is presented.