Affiliation:
1. Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University Guangzhou China
Abstract
There has been increasing application of autologous costal chondral/osteochondral transplantation (ACCT/ACOT) and costa‐derived chondrocyte implantation (ACCI) for articular cartilage repair over the past three decades. This review presents the major evidence on the properties of costal cartilage and bone and their qualifications as grafts for articular cartilage repair, the major clinical applications, and the risks and strategies for costal chondral/osteochondral graft(s) harvest. First, costal cartilage has many specific properties that help restore the articular surface. Costa, which can provide abundant cartilage and cylindrical corticocancellous bone, preserves permanent chondrocyte and is the largest source of hyaline cartilage. Second, in the past three decades, autologous costal cartilage‐derived grafts, including cartilage, osteochondral graft(s), and chondrocyte, have expanded their indications in trauma and orthopaedic therapy from small to large joints, from the upper to lower limbs, and from non‐weight‐bearing to weight‐bearing joints. Third, the rate of donor‐site complications of ACCT or ACOT is low, acceptable, and controllable, and some skills and accumulated experience can help reduce the risks of ACCT and ACOT. Costal cartilage‐derived autografting is a promising technique and could be an ideal option for articular chondral lesions with or without subchondral cysts. More high‐quality clinical studies are urgently needed to help us further understand the clinical value of such technologies.
Subject
Orthopedics and Sports Medicine,Surgery
Reference55 articles.
1. Osteochondritis Dissecans: current understanding of epidemiology, etiology, management, and outcomes;Chau MM;J Bone Joint Surg Am,2021
2. Operative treatment of osteochondral lesions of the talar dome: current concepts review;Giannini S;Foot Ankle Int,2004
3. The basic science of articular cartilage: structure, composition, and function;Sophia Fox AJ;Sports Health,2009
4. Operative treatment of osteochondral lesions of the talus;Murawski CD;J Bone Joint Surg Am,2013
5. Limited evidence of adjuvant biologics with bone marrow stimulation for the treatment of osteochondral lesion of the talus: a systematic review;Seow D;Knee Surg Sports Traumatol Arthrosc,2022