[Cartilage cell transplantation. Experimental principles and clinical applications]

Transplantation of autologous chondrocytes proliferated in vitro to treat 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 of joints in the long term. Facial cartilage defects may lead to aesthetic or functional problems. Different biological and synthetic substitutes were used to treat cartilage defects in orthopaedic and facial plastic surgery. Biological tissue for transplantation is not abundant and synthetic materials may induce foreign body reactions. Amplification of autologous cells in vitro to produce a tissue similar to the impaired tissue seems tempting. It is transplantable into the defect and is tough to restore the defective surface completely. This is the intention of numerous scientific investigations concerning chondrocyte application to cartilage defects. Transplantation of isolated chondrocytes is currently used in clinical trials also. The possibilities and limitations of this technique are discussed including the fundamental principles and our own experimental investigations. A proof for the reproduction of a tissue similar to native cartilage with its typical long term mechanical properties is still missing. Further laboratory and clinical studies should be conducted before the technique is propagated in patient care.