Autologous chondrocyte transplantation (ACT) provides a durable hyaline repair tissue in correctly selected indications. Autologous chondrocyte transplantation is indicated for full-thickness, weight-bearing condyle injuries and injuries to the trochlea of the femur. ACT results in reproducibly satisfactory results with return to high-level activities including sports in over 90% of the patients. Second-look arthroscopies demonstrate tissue fills wth biopsies showing hyaline-like cartilage repair. Hyaline cartilage repair is critical because this has been shown clinically to give long standing results with follow-up at 2 to 9 years. As technical refinements improve, and rehabilitation protocols, results for injuries to the patellar and the tibia will improve. At this time the response to treating bipolar focal chondral injuries is unknown and not recommended.