Cartilage duplication is not yet possible. In the last 20 years pieces of joint cartilage have been harvested but the resultant growth for re-implantation has been less than ideal. Our normal cartilage has stratified layers. Getting the stratification the same has been the let down in cartilage stem cell duplication. The total ankle replacement has been more sucessfull and can be considered when the ankle arthritis is limiting and painful enough.