Future perspectives of articular cartilage repair

Extrapolating from the current state of the art in cartilage repair technology and basic science, we describe the future of regenerative medicine in the musculoskeletal system. Crucial milestones that have been recognized include supply with competent cells from autologous to xenogeneic sources, “intelligent” or “reactive” scaffold design, optimised application of humoral factors and the introduction of advanced gene-engineering technology. Besides these technical goals, ethical and legal considerations may significantly change the way pharmacological and medical components are recruited and regulated. At the same time, governmental regulatory bodies will have to accept new realities such as the existence of adaptive medical devices and of biological combination implants that are anywhere between a drug and a transplanted organ. For cartilage replacement itself, optimism seems to be justified regarding major advances within the next decade.