The effect of perichondrium on cartilage graft properties

Abstract

Purpose of review The role of perichondrium in cartilage graft survival has been long debated. Although the innate function of perichondrium in providing mechanical and regenerative support to cartilage in its native position is relatively undisputed, studies continue to vacillate over how the perichondrium effects cartilage grafts once transplanted. This review evaluates historical and recent experiments showing how perichondrium may or may not impact graft survival. Recent findings Experimental studies in animal models have more recently evaluated macroscopic and microscopic properties of diced cartilage grafts with and without perichondrium, finding that in general grafted cartilage with perichondrial components retains greater weight and mechanical strength compared with cartilage without perichondrial components. However, these findings have not been replicated in humans. Solid pieces of rib cartilage have most recently been used without perichondrium to prevent warping, though no studies have evaluated whether retaining perichondrium with oblique and concentric cutting techniques may effect overall resorption. Summary Although historical opinions and more recent animal studies suggest a role of perichondrium in cartilage graft survival, randomized controlled human studies are still lacking on whether retaining perichondrium truly effects graft survival and ultimate surgical outcomes.

Craniofacial chondrogenesis in organoids from human stem cell-derived neural crest cells

“… 47 The regeneration of ear cartilage tissue is much more successful if perichondrium is employed, due to the presence of chondroprogenitor cells. 36 , 39 , 48 Rhinoplasty grafts with perichondria components also look promising from animal studies, but evidence is lacking for humans. 48 Nasal chondrocytes are neural crest-lineage chondrocytes that retain some proliferative potential and have the ability to repair articular cartilage with even greater chondrogenic capacity than mesenchyme-derived chondrocytes.…”

“… 36 , 39 , 48 Rhinoplasty grafts with perichondria components also look promising from animal studies, but evidence is lacking for humans. 48 Nasal chondrocytes are neural crest-lineage chondrocytes that retain some proliferative potential and have the ability to repair articular cartilage with even greater chondrogenic capacity than mesenchyme-derived chondrocytes. 44 , 49 , 50 , 51 For example, isolated human nasal septal chondrocytes have been successfully grafted to mice, expanded, applied to synthetic polymers to facilitate injection, and then used for reconstruction.…”

Cartilage’s Contribution in Otology: A Comprehensive Review of Its Role in Ear Surgery

“…By safeguarding the perichondrium, surgeons enhance the chances of graft survival, as the preserved vascular support facilitates nutrient diffusion and fosters the graft's integration with the recipient site. This nuanced approach to perichondrial preservation exemplifies the importance of meticulous surgical techniques in optimizing the success of cartilage grafts in otologic surgery [ 22 ].…”