Characterization of costal cartilage allografts

Abstract

Background: Human costal cartilage remains widely used in the reconstruction of soft tissues, particularly within the field of plastic and orthopaedic surgery. The biologic expense of using autologous human costal cartilage has become superseded by the increasingly common use of irradiated costal cartilage allografts. To date, there has been no histologic investigation of such costal cartilage allografts. This study aims to characterize the histologic variations that exist between different costal cartilage specimens, and to quantify this between specimens in spite of their common anatomical derivation. Methods: Twenty-five specimens of cadaveric human costal cartilage were obtained from Australian Biotechnologies. Each specimen was irradiated, sectioned and stained with Haematoxylin and Eosin, Masson's trichrome and tetrachrome stains. After being analysed under light microscopy, specimen dimensions, chondrocyte counts and mineral content was quantified and measured. Results: The median specimen diameter was 8.20 mm, with an interquartile range (IQR) of 1.59 mm. The median measurement from the superficial to basal chondrocyte layer was 1409.91 μm (IQR = 885.59 μm), and the median measurement from superficial to calcified zone was 4146.26 μm (IQR 1441.83 μm). The median chondrocyte area was 442.74 μm 2 (IQR = 2622.72 μm 2 ) with their total chondrocyte count ranging from 289 to 591 chondrocytes per square millimetre. The median percentages of collagen and mineral content were 45.17% and 71.82%, respectively (IQR = 20.48%, 14.75%). Conclusion: These findings emphasize the histologic and biochemical degree of variation that exists between specimens of human cadaveric costal cartilage on a microscopic level. This has the potential to influence the selection of costal cartilage allografts for reconstructive purposes.

Primary Ear Reconstruction Using Cadaveric Costal Cartilage

“…[12][13][14] For this reason, in addition to the elimination of donor site morbidity and biologic expense associated with autologous cartilage harvesting, the use of CCC has gained popularity in the field of plastic surgery. 15 Our preliminary experience has shown short-term maintenance of cartilage integrity on clinical assessment along with excellent overall tolerance of CCC evidenced by potential repopulation of lacuna with cells and restoration of aggrecan production on histology. These findings, along with positive longitudinal data from the nasal reconstruction literature, suggest that CCC may have a lower likelihood of resorption than the allogeneic cartilage used in the past.…”

“…In studies exploring the safety of CCC grafts in rhinoplasty, when comparing the use of autologous grafts to cadaveric cartilage grafts, the findings demonstrated no significant difference in complications, such as resorption, warping, extrusion, contour irregularity, and infection, between the 2 groups 12–14 . For this reason, in addition to the elimination of donor site morbidity and biologic expense associated with autologous cartilage harvesting, the use of CCC has gained popularity in the field of plastic surgery 15 …”

Second Harmonic Imaging of Nasal, Auricular, and Costal Cartilage

“…This study analyzed ECM organization, cellular size, and cellular density of facial and costal cartilages. Previous studies have indicated that facial and costal cartilages are different from each other through the use of light microscopy 11 . However, through the use of SHG microscopy, we are the first to specifically visualize signal intensity of type II collagen to discern ECM differences between surgical remnant human facial and costal cartilages.…”

“…Previous studies have indicated that facial and costal cartilages are different from each other through the use of light microscopy. 11 However, through the use of SHG microscopy, we are the first to specifically visualize signal intensity of type II collagen to discern ECM differences between surgical remnant human facial and costal cartilages. It is important to note that individual collagen fibrils were not resolved because the size of the fibrils is smaller than the diffraction limit of optical microscopy.…”