Autologous chondrocyte implantation is now established as a successful treatment for many patients with osteochondral injuries of the knee. Indications, preoperative preparation, operative technique, post-operative management and rehabilitation are detailed. Newer developments such as matrix-assisted chondrocyte implantation (MACI) and “multilayer” repair are possible for filling deep bony defects. Anterior cruciate ligament repair and para-articular osteotomy for realignment of the tibio-femoral joint are also possible. Realignment procedures of the patella-femoral joint are essential where there is mal-tracking. The published results over a 10-year period indicate that 80% of patients have a satisfactory outcome. Autologous stem cells show promise for similar results by a “one-step” procedure and accelerated rehabilitation.
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