Autologous chondrocyte transplantation introduced cell therapy in the treatment of a pathologic condition in the locomotors stem, particularly in cartilage repair. The use of biomaterials as scaffolds for transplantation assured cell delivery and supported cell behavior toward the chondrocytic phenotype to provide a chondrogenic potential to regenerate articular cartilage . Furthermore, it allowed developing improved surgical techniques to address more challenging damage with a less-invasive approach by more efficient fixation methods. Overall, a successful cell transplantation can be expected in 75%-80% of patients younger than 40 years and in isolated cartilage defects. However, ultimate goals of tissue engineering are to regenerate the articular cartilage to normal and provide a sustainable long-term joint surface and to avoid deterioration of an initial cartilage defect to osteoarthritis and progressive joint damage. Now 20 years after the first publication, the newly developed techniques have to prove whether they are able to produce sufficient long-term outcomes. Studies with follow-up periods of approximately 5 years or longer are presented and analyzed in the context of sustainability for joint function and whether the promise of healing cartilage has come true at last.