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From gristle to chondrocyte transplantation: treatment of cartilage injuries

Journal article
Authors Anders Lindahl
Published in Philosophical Transactions of the Royal Society B-Biological Sciences
Volume 370
Issue 1680
Pages Article nr. 20140369
ISSN 0962-8436
Publication year 2015
Published at Institute of Biomedicine
Pages Article nr. 20140369
Language en
Keywords cartilage, stem cells, cell therapy, human articular chondrocytes, pluripotent stem-cells, chondrogenic, differentiation, osteochondral defects, intervertebral disc, hip, osteoarthritis, knee-joint, implantation, repair, identification, Life Sciences & Biomedicine
Subject categories Biological Sciences


This review addresses the progress in cartilage repair technology over the decades with an emphasis on cartilage regeneration with cell therapy. The most abundant cartilage is the hyaline cartilage that covers the surface of our joints and, due to avascularity, this tissue is unable to repair itself. The cartilage degeneration seen in osteoarthritis causes patient suffering and is a huge burden to society. The surgical approach to cartilage repair was non-existing until the 1950s when new surgical techniques emerged. The use of cultured cells for cell therapy started as experimental studies in the 1970s that developed over the years to a clinical application in 1994 with the introduction of the autologous chondrocyte transplantation technique (ACT). The technology is now spread worldwide and has been further refined by combining arthroscopic techniques with cells cultured on matrix (MACI technology). The non-regenerating hypothesis of cartilage has been revisited and we are now able to demonstrate cell divisions and presence of stem-cell niches in the joint. Furthermore, cartilage derived from human embryonic stem cells and induced pluripotent stem cells could be the base for new broader cell treatments for cartilage injuries and the future technology base for prevention and cure of osteoarthritis.

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