{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:40:32Z","timestamp":1792194032264,"version":"4.4.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cell-based cartilage repair strategies seek biologic regeneration of articular cartilage rather than mechanical resurfacing. These approaches are most appropriate for medium-to-large, contained focal defects in patients who have preserved alignment and subchondral bone who are willing to undergo staged procedures and prolonged rehabilitation. Autologous chondrocyte implantation, particularly in its matrix-induced form, represents the most established cell-based platform. Long-term follow-up studies demonstrate sustained improvements in patient-reported outcomes with acceptable reoperation and arthroplasty conversion rates beyond 10 years. Evidence remains the strongest for the technique as a class rather than for individual proprietary systems. In contrast, point-of-care orthobiologics, including bone marrow aspirate concentrate and platelet-rich plasma, are widely utilized despite heterogeneous protocols and limited high-level comparative data. Although short-term symptomatic improvements are frequently reported, structural imaging outcomes and durability remain inconsistent. Standardization challenges complicate interpretation of the existing literature. Emerging therapies, including adipose-derived regenerative cell systems, cord blood\u2013derived mesenchymal stem cell constructs, and tissue-engineered osteochondral platforms, aim to enhance biologic regeneration while reducing procedural burden. Most remain investigational, with early-phase clinical trials and limited long-term outcome data. Cell-based repair occupies a distinct position within the joint-preserving continuum. Durable success depends on careful alignment between lesion characteristics and biologic plausibility. Failures often reflect application beyond appropriate constraints rather than technical inadequacy. Continued comparative studies are necessary to define durability, cost-effectiveness, and long-term joint preservation relative to structural and hybrid strategies.<\/jats:p>","DOI":"10.1055\/a-2865-1851","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T22:31:31Z","timestamp":1778797891000},"page":"688-692","source":"Crossref","is-referenced-by-count":1,"title":["Contemporary Management of Knee Chondral Defects, Part III: Cell-Based Cartilage Repair Including Autologous Chondrocyte Implantation, Orthobiologics, and Tissue-Engineered Constructs"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8509-8120","authenticated-orcid":false,"given":"Chase W.","family":"Smitterberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, LifeBridge Health Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Mont","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, LifeBridge Health Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles R.","family":"Scuderi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1177\/03635465231205309","article-title":"Minimum 10-year outcomes of matrix-induced autologous chondrocyte implantation in the knee: a systematic review","volume":"52","author":"A S Wang","year":"2024","journal-title":"Am J Sports Med"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1177\/1947603514563597","article-title":"Matrix-induced autologous chondrocyte implantation versus multipotent stem cells for the treatment of large patellofemoral chondral lesions: a nonrandomized prospective trial","volume":"6","author":"A Gobbi","year":"2015","journal-title":"Cartilage"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"2325967115625481","DOI":"10.1177\/2325967115625481","article-title":"Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee: a systematic review of outcomes","volume":"4","author":"J Chahla","year":"2016","journal-title":"Orthop J Sports Med"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1007\/s11999-011-2107-4","article-title":"A cell-free scaffold-based cartilage repair provides improved function hyaline-like repair at one year","volume":"470","author":"A Siclari","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1016\/j.arth.2022.05.014","article-title":"The efficacy of platelet-rich plasma for the treatment of knee osteoarthritis symptoms and structural changes: a systematic review and meta-analysis","volume":"37","author":"O C Sax","year":"2022","journal-title":"J Arthroplasty"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.2217\/rme-2020-0027","article-title":"Evaluation of autologous adipose-derived mesenchymal stem cell therapy in focal chondral defects of the knee: a pilot case series","volume":"15","author":"J Freitag","year":"2020","journal-title":"Regen Med"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"355","DOI":"10.2217\/rme-2022-0002","article-title":"Real-world evidence of mesenchymal stem cell therapy in knee osteoarthritis: a large prospective two-year case series","volume":"17","author":"J Freitag","year":"2022","journal-title":"Regen Med"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1002\/ksa.12100","article-title":"Implantation of hUCB-MSCs generates greater hyaline-type cartilage than microdrilling combined with high tibial osteotomy","volume":"32","author":"S H Jung","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"195","DOI":"10.5604\/15093492.1058409","article-title":"Osteochondral lesions of the knee reconstructed with mesenchymal stem cells - 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