Ankle chondral injuries and repair.

The success of cartilage repair in the ankle and other joints rests on multiple factors. Because native cartilage healing fails to produce hyaline, organized cartilage, the challenge lies in activating an appropriate healing response. The combination of an optimal structural matrix, infusion of pleuripotent cells, and gene-modified tissue engineering to activate an appropriate healing response appears most sensible. Until such technology is available for use in humans, however, autologous chondrocyte transplantation and osteochondral transfer procedures are attractive alternatives.