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Articular cartilage together with the synovial fluid acts as a mechanical shock absorber, provides lubrication for gliding joint surfaces, and serves as an elastic connection between the articulating joint surfaces. It contains relatively few cells, the chondrocytes, but no blood or lymph vessels or nerves. Cartilaginous tissue has a very limited capacity for self-regeneration; therefore, techniques for cell-based cartilage repair were developed in the mid-nineties of the last century. For such therapies mature chondrocytes are harvested from healthy cartilage of the affected joint and implanted into the defect after in vitro expansion. This therapy works well if chondrocytes from donor tissue are available. In this chapter we discuss recent progress in cell-based tissue engineering utilizing chondrogenic progenitor cells (so-called mesenchymal stem/stromal cells (MSCs)) as surrogate cell source. The MSC characteristics, their potential but also their limitations in MSC-based cartilage repair will be discussed. In addition, the reader will be introduced to some of the current tasks in developing MSC-based therapies for the health market.

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