Autologous Chondrocyte Transplantation (ACT) — Long-Term Results

Problems associated with the treatment of an injury to the hyaline articular cartilage are known since a long time and are still greatly discussed [6]. An injury that extends through all layers of cartilage down to the subchondral bone, or even through the bone, is likely to progress to osteoarthritis by degradation through a combination of mechanical wear and enzymatic digestion [3]. To detect and treat a cartilage injury at an early stage before it leads to a vast joint destruction is therefore of outmost importance. Current therapies including drilling, abrasion and microfracturing are introducing mesenchymal progenitor cells from the bone marrow to provide a repair tissue. However, this repair tissue may end up in fibrous tissue, which over time will not stand wear and load of the joint. Buckwalter stated in 1990 “the ultimate measure of cartilage repair must be the degree of restoration of synovial joint function following an injury that alters joint function meaning not necessarily repair tissue of identical morphological structure” [4].