Cartilage Transplantation Research Articles

A new corrective method for the Tanzer’s group IIB constricted ear: Helical expansion using V-Y advancement flap combined with concha cartilage graft

BackgroundThe complexity of the constricted ear's shape renders a uniform surgical method unattainable, thus posing an ongoing challenge in its correction. The Tanzer’s group IIB constricted ear is characterized by a prominent downward folding, an underdeveloped antihelix, and the absence of sacpha. The present study utilized a V-Y advancement flap combined with concha cartilage for the repair of Tanzer’s group IIB constricted ear. MethodFrom September 2016 to September 2022, a total of 16 patients diagnosed with type IIB ear constriction were enrolled in this retrospective study. The correction procedure for constricted ear involved the utilization of a V-Y advancement flap combined with concha cartilage graft. The auricle shape data of the patients, as well as their VAS satisfaction score and auricle aesthetic score, were examined both preoperatively and 12 months postoperatively. ResultThe mean duration of follow-up in this study was 18 months. The postoperative measurements of ear length, ear width, bilateral differences in ear length, and bilateral differences in ear width exhibited significant improvement compared to preoperative values. The mean preoperative AOS score was 1.12±0.34, while the mean postoperative AOS score increased to 3.81±0.40. The preoperative VAS satisfaction score was recorded as 2.31±0.70, while the postoperative VAS score significantly increased to 8.00±0.89. The follow-up period did not present any cases of flap necrosis, hematoma, infection, or wound dehiscence. ConclusionThe combination of V-Y advancement flap and concha cartilage transplantation for the correction of Tanzer’s group IIB constricted ear can achieve a natural and aesthetically pleasing auricle shape, resulting in high patient satisfaction.

A Technique of Autologous Costal Cartilage Graft Combined With Auricular Cartilage Folding to Correct Question Mark Ear in a Single Procedure.

Background: Question mark ear is a rare congenital deformity, mainly characterized the interruption of the natural continuity between the lower border of the helix and the earlobe. In severe cases, the earlobe may be absent. In addition, there may be protrusion and outward expansion of the upper part of the auricle, with partial or complete disappearance of the antihelix. This article aims to introduce a technique that combines autologous costal cartilage carving with auricular cartilage folding to achieve a stable and aesthetic auricle. Method: This study included 26 patients with sporadic question mark ear deformity who were treated at our clinical center from January 2020 to December 2022. Based on the different appearances of the lower part of the auricle, they were divided into 2 categories:11 cases showed a natural continuity interruption between the helix and the earlobe, while 15 cases showed the absence of the earlobe. All patients underwent corrective surgery using costal cartilage transplantation combined with the upper part of the auricular cartilage folding, performed by senior surgeons. Results: Question mark ear was effectively improved and with no significant rebound. The average follow-up period was 8.4 months (ranging from 6 to 12 months). A satisfaction survey showed that 23 patients (88%) were satisfied, 3 patients (12%) were partially satisfied, and no patients were dissatisfied. Most patients experienced temporary swelling after surgery, which resolved within 3 months to half a year. Conclusion: Autologous costal cartilage transplantation combined with folding of the auricular cartilage is an ideal surgical method to correct question mark ear.

Theoretical aspects regarding the use of autologous and allogeneic septal cartilage transplantation in rhinologic surgical procedures

The study examines the use of autologous and allogeneic septal cartilage transplantation in rhinoplasty and rhi­no­sep­to­plasty. Innovative surgical techniques such as endoscopic and open septal cartilage harvesting were examined, high­ligh­ting advantages such as faster postoperative re­co­very and better visualization of nasal anatomy, as well as dis­ad­van­tages such as a steep learning curve and com­pli­ca­tions as­so­cia­ted with endoscopic manipulation. The postoperative out­­comes of patients undergoing rhinoplasty with auto­lo­gous car­ti­lage implants showed increased satisfaction re­gar­ding na­sal esthetic appearance and functionality. Re­gar­ding al­lo­ge­neic cartilage transplantation, risks of re­jec­tion and in­fec­tion were highlighted. Future perspectives in sep­tal car­ti­lage transplantation included improving surgical tech­­niques and optimizing outcomes, as well as exploring the use of innovative materials and technologies for cartilage tissue regeneration and remodeling. Aspects related to the in­te­gra­tion and revitalization of transplanted cartilage were studied in detail, including processes of angiogenesis, cel­lular colonization, and extracellular matrix biosynthesis. Sur­geons’ preferences regarding the use of autologous or al­lo­ge­neic cartilage were examined, highlighting the reasons and criteria underlying their choices. In conclusion, cartilage trans­plants are effective and safe in rhinologic surgical inter­ven­tions, although the study has limitations related to source avai­la­bi­lity and methodological variability.

Adipose-derived mesenchymal stem cell-incorporated PLLA porous microspheres for cartilage regeneration.

In facial plastic surgery, patients with nasal deformity are often treated by rib cartilage transplantation. In recent years, cartilage tissue engineering has developed as an alternative to complex surgery for patients with minor nasal defects via injection of nasal filler material. In this study, we prepared an injectable nasal filler material containing poly-L-lactic acid (PLLA) porous microspheres (PMs), hyaluronic acid (HA) and adipose-derived mesenchymal stem cells (ADMSCs). We seeded ADMSCs into as-prepared PLLA PMs using our newly invented centrifugation perfusion technique. Then, HA was mixed with ADMSC-incorporated PLLA PMs to form a hydrophilic and injectable cell delivery system (ADMSC-incorporated PMH). We evaluated the biocompatibility of PMH invitro and invivo. PMH has good injectability and provides a favorable environment for the proliferation and chondrogenic differentiation of ADMSCs. Invivo experiments, we observed that PMH has good biocompatibility and cartilage regeneration ability. In this study, a injectable cell delivery system was successfully constructed. We believe that PMH has potential application in cartilage tissue engineering, especially in nasal cartilage regeneration.

Mesenchymal stem cells in craniofacial reconstruction: a comprehensive review.

Craniofacial reconstruction faces many challenges, including high complexity, strong specificity, severe injury, irregular and complex wounds, and high risk of bleeding. Traditionally, the "gold standard" for treating craniofacial bone defects has been tissue transplantation, which involves the transplantation of bone, cartilage, skin, and other tissues from other parts of the body. However, the shape of craniofacial bone and cartilage structures varies greatly and is distinctly different from ordinary long bones. Craniofacial bones originate from the neural crest, while long bones originate from the mesoderm. These factors contribute to the poor effectiveness of tissue transplantation in repairing craniofacial defects. Autologous mesenchymal stem cell transplantation exhibits excellent pluripotency, low immunogenicity, and minimally invasive properties, and is considered a potential alternative to tissue transplantation for treating craniofacial defects. Researchers have found that both craniofacial-specific mesenchymal stem cells and mesenchymal stem cells from other parts of the body have significant effects on the restoration and reconstruction of craniofacial bones, cartilage, wounds, and adipose tissue. In addition, the continuous development and application of tissue engineering technology provide new ideas for craniofacial repair. With the continuous exploration of mesenchymal stem cells by researchers and the continuous development of tissue engineering technology, the use of autologous mesenchymal stem cell transplantation for craniofacial reconstruction has gradually been accepted and promoted. This article will review the applications of various types of mesenchymal stem cells and related tissue engineering in craniofacial repair and reconstruction.

Responsiveness of Patient-Reported Outcome Measures After Large Knee Articular Cartilage Transplantation: A Systematic Review and Meta-analysis

Background: Cartilage transplantation is commonly used to treat large (>4 cm2) articular cartilage defects of the knee. The 2 most common transplants are osteochondral allograft transplantation and autologous chondrocyte implantation. Several patient-reported outcome measures (PROMs) have been used to determine the efficacy of treatment, but it is unknown which measures are the most effective. Purpose: To report the multiple PROMs used after large knee articular cartilage transplantation surgery and to compare the responsiveness between them. Study Design: Meta-analysis; Level of evidence, 4. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of the PubMed/MEDLINE and Web of Science databases was performed. A total of 181 articles met inclusion criteria. Patient and study characteristics were extracted, including pre- and postoperative means for PROMs. From the articles that met inclusion criteria for responsiveness analysis (2+ PROMs reported, 1-year minimum follow-up, reported pre- and postoperative means and standard deviations; n = 131), the authors compared the responsiveness between PROM instruments using effect size and relative efficiency (RE) if a PROM could be compared with another in ≥10 articles. Results: A total of 10,015 patients (10,093 knees; mean age, 34.8 years; mean body mass index, 26.1) were included in this study. The mean follow-up time was 58.3 months (range, 1.5-247.2 months), imaging findings were reported in 80 articles (44.2%), patient satisfaction was reported in 39 articles (21.5%), and range of motion was reported in 10 articles (5.5%). There were 58 unique PROM instruments identified, with the most used being the International Knee Documentation Committee (IKDC) score (n = 118; 65.2%), followed by Knee injury and Osteoarthritis Outcome Score (KOOS) Pain (n = 58; 32.0%), KOOS Sport and Recreation (n = 58; 32.0%), KOOS Quality of Life (n = 57; 31.5%), KOOS Activities of Daily Living (n = 57; 31.5%), and KOOS Symptoms (n = 57; 31.5%). Overall, IKDC was found to have the greatest effect size (1.68) and the best responsiveness of the other PROMs, which include KOOS Pain (RE, 1.38), KOOS Symptoms (RE, 3.06), KOOS Activities of Daily Living (RE, 1.65), KOOS Sport and Recreation (RE, 1.44), Lysholm (RE, 1.76), and Tegner (RE, 1.56). Conclusion: The IKDC is the most responsive PROM after large knee articular cartilage transplantation surgery. The IKDC score is recommended for assessing outcomes after cartilage transplantation surgery.

Impact of Wiberg Patellar Type on Outcomes and Survival Following Cell-Based Cartilage Repair for Patellar Chondral Lesions at Midterm Follow-up.

Cell-based cartilage repair procedures of the patellofemoral joint have less reliable outcomes than those of the tibiofemoral joint. No previous studies have evaluated the influence of patellar shape on cell-based cartilage repair outcomes. Patellar dysplasia may predispose patients to worse outcomes after cell-based cartilage repair. The purpose of this study was to evaluate the relationship between Wiberg patellar type and outcomes after cell-based cartilage repair (autologous chondrocyte implantation or particulated juvenile allograft cartilage transplantation) for the treatment of patellar chondral lesions at a minimum 2-year follow-up. It was hypothesized that Wiberg classification of patellar shape would have no effect on patient-reported outcome measures (PROMs) or graft survival. Cohort study; Level of evidence, 3. Patients undergoing autologous chondrocyte implantation or particulated juvenile allograft cartilage transplantation for full-thickness patellar chondral defects between 2016 and 2020 were retrospectively reviewed after institutional review board approval. The change in PROMs, including International Knee Documentation Committee (IKDC), Kujala, and Veterans RAND 12-item Health Survey Mental and Physical scores, from pre- to postoperatively and the percentage of patients who achieved the minimal clinically important difference (MCID) for IKDC and Kujala scores were compared for the Wiberg type A versus Wiberg type B versus Wiberg type C groups. The log-rank test was used to evaluate for differences in survival between subgroups. A total of 59 patients (63 knees) were included, with a mean age of 33.3 ± 8.6 years, median body mass index of 26.0 (IQR, 21.8-30.2), and median follow-up time of 3.5 years (IQR, 2.6-4.2 years). In total, 26 (41%) patellae were Wiberg type A, 29 (46%) were Wiberg type B, and 8 (13%) were Wiberg type C. There were no differences between Wiberg type A versus Wiberg type B versus Wiberg type C groups with respect to change in PROMs from pre- to postoperatively or the percentage of patients who achieved the MCID for IKDC or Kujala scores (P > .05 for all). There were no differences in survival between groups (P = .45). Wiberg patellar type has no effect on patient-reported outcomes or graft survival at midterm follow-up. Patellar dysplasia should not be seen as a contraindication for cell-based cartilage repair procedures.

Comparing both Open and Closed Techniques in Rhinoplasty

Rhinoplasty is a surgical technique used to restore and modify nasal tissues for both functional and aesthetic reasons. There are two primary methods for doing a rhinoplasty: open and closed. While both methods change the bone and cartilage, there are variations in the ways that the nasal components are reached. Both open and closed rhinoplasty have changed significantly over the past 20 years due to the introduction of various cartilage transplants, sutures, and improvements in surgical technology. Rhinoplasty is a very difficult procedure that calls for a high level of expertise and training from physicians. Because of the lifelong learning curve, the surgeon's skill set—rather than their technique—determines the best possible patient outcomes.

Nuclear Factor-κB Decoy Oligodeoxynucleotide Attenuates Cartilage Resorption In Vitro.

Cartilage harvest and transplantation is a common surgery using costal, auricular, and septal cartilage for craniofacial reconstruction. However, absorption and warping of the cartilage grafts can occur due to inflammatory factors associated with wound healing. Transcription factor nuclear factor-κB (NF-κB) is activated by the various stimulation such as interleukin-1 (IL-1), and plays a central role in the transactivation of this inflammatory cytokine gene. Inhibition of NF-κB may have anti-inflammatory effects. The aim of this study was to explore the potential of an NF-κB decoy oligodeoxynucleotide (Decoy) as a chondroprotective agent. Safe and efficacious concentrations of Decoy were assessed using rabbit nasal septal chondrocytes (rNSChs) and assays for cytotoxicity, proteoglycan (PG) synthesis, and PG turnover were carried out. The efficacious concentration of Decoy determined from the rNSChs was then applied to human nasal septal cartilage (hNSC) in vitro and analyzed for PG turnover, the levels of inflammatory markers, and catabolic enzymes in explant-conditioned culture medium. Over the range of Decoy conditions and concentrations, no inhibition of PG synthesis or cytotoxicity was observed. Decoy at 10 μM effectively inhibited PG degradation in the hNSC explant, prolonging PG half-life by 63% and decreasing matrix metalloprotease 3 (MMP-3) by 70.7% (p = 0.027). Decoy may be considered a novel chondroprotective therapeutic agent in cartilage transplantation due to its ability to inhibit cartilage degradation due to inflammation cytokines.

Particulated autologous cartilage transplantation for the treatment of osteochondral lesion of the talus: can the lesion cartilage be recycled?

AimsOsteochondral lesions of the talus (OLT) are a common cause of disability and chronic ankle pain. Many operative treatment strategies have been introduced; however, they have their own disadvantages. Recently lesion repair using autologous cartilage chip has emerged therefore we investigated the efficacy of particulated autologous cartilage transplantation (PACT) in OLT.MethodsWe retrospectively analyzed 32 consecutive symptomatic patients with OLT who underwent PACT with minimum one-year follow-up. Standard preoperative radiography and MRI were performed for all patients. Follow-up second-look arthroscopy or MRI was performed with patient consent approximately one-year postoperatively. Magnetic resonance Observation of Cartilage Repair Tissue (MOCART) score and International Cartilage Repair Society (ICRS) grades were used to evaluate the quality of the regenerated cartilage. Clinical outcomes were assessed using the pain visual analogue scale (VAS), Foot Function Index (FFI), and Foot Ankle Outcome Scale (FAOS).ResultsAll patients had ICRS grade IV cartilage lesions, except for one (ICRS grade III). The paired MOCART scores significantly improved from 42.5 (SD 1.53) to 63.5 (SD 22.60) (p = 0.025) in ten patients. Seven patients agreed to undergo second-look arthroscopy; 5 patients had grade I (normal) ICRS scores and two patients had grade II (nearly normal) ICRS scores. VAS, FFI, and all subscales of FAOS were significantly improved postoperatively (p ≤ 0.003).ConclusionPACT significantly improved the clinical, radiological, and morphological outcomes of OLT. We consider this to be a safe and effective surgical method based on the short-term clinical results of this study.Cite this article: Bone Jt Open 2023;4(12):942–947.

Outcomes of nanowarmed vitrified articular cartilage transplantation in a porcine model

Outcomes of nanowarmed vitrified articular cartilage transplantation in a porcine model

Effect of Nasal Tip Reshaping on Tip Projection in Primary Rhinoplasty without Cartilage Grafting from a Second Donor Site in an Asian Population

Objectives: Many Asian patients with nasal aesthetic surgery desire a sharper, more defined nasal tip. In many cases, their nasal cartilage is not abundant enough, necessitating cartilage transplantation from an extranasal location. We investigated which patients would qualify for a method of reshaping the nasal tip without needing donor cartilage by reshaping the lower cartilage using the transdomal suture technique and local cartilage grafting.Methods: We performed a single-center retrospective cohort study of patients undergoing nasal tip surgery. We divided patients into two groups. Group 1 comprised 13 patients with nasal tips with thin skin and soft tissue and relatively abundant cartilage. Group 2 included 31 patients with nasal tips with thicker, firmer skin and soft tissue and a smaller amount of cartilage. No patients had prior nasal surgery, and all patients were followed up for at least 3 months. Patients in both groups underwent the transdomal suture technique and local cartilage grafting. Five patients in Group 2 underwent alar reduction. Preoperative and postoperative lateral view photographs were superimposed and analyzed to measure changes in tip projection.Results: Patients in Group 1 showed a mean increase in tip projection of 3.9%. Patients in Group 2 demonstrated a mean decrease in tip projection of −1.5% without alar reduction and −5.6% with alar reduction.Conclusions: If the nasal tip is predominantly cartilaginous, patients may undergo surgery that does not involve donor cartilage from another site with good results. However, most patients, who have a relatively small amount of nasal tip cartilage, are not good candidates for this procedure.

Caudal septal extension grafts: conchal cartilage or PDS foil-empowered nasal cartilage.

We reviewed the potential benefits of conchal cartilage or Polydioxanone (PDS) foil-empowered nasal cartilage as caudal septal extension grafts (CSEGs). Research methods included searching online databases such as Google, Google Scholar, PubMed, and Proquest Central at Kırıkkale University. Use terms like "caudal septal extension grafts," "septal extension grafts," "conchal cartilage," and "PDS foil-empowered nasal cartilage" to find related articles. Due to the anchoring of the lower alar cartilage to the nasal septum, the results of a CSEG rhinoplasty are relatively stable over the long term. They can be adjusted independently by the rhinoplasty surgeon. Over time, the skin and soft tissue envelope contract and a downward force for these grafts develops. It allows for independent regulation of projection and rotation, unlike conventional columellar strut procedures and lateral crural steal techniques. Inadequate cartilage may need conchal or costal cartilage, depending on the application and the need for projection and counter rotation. Costal cartilage transplant outperformed conchal cartilage graft in a rabbit model regarding tip projection and angle relapse rate. Three-patient case series show that PDS foil-enhanced nasal cartilage led to septal cartilage loss. However, other research draws a different result, finding that PDS foil-enhanced nasal cartilage prevented growth inhibition in the developing nasal septum following septoplasty, and reduced late problems in animals. The caudal septal extension grafts should prioritize septum cartilage if it is readily available, of adequate size, and with sufficient strength. If this is not possible, PDS foil-enhanced nasal cartilage fragments or conchal cartilage could be used as a backup. PDS foil will maintain the integrity and stability of the implanted cartilage. Due to its strength, stability, and convenient location, conchal cartilage will serve as the second donor site.

Application of Chitosan-Based Polysaccharide Biomaterials in Tissue Engineering

Chitosan-based polysaccharide biomaterials have gained interest as viable options in tissue engineering due to their distinctive properties and wide range of potential applications. Biomaterials play a crucial role in regenerative medicine because they foster an environment conducive to cell growth and tissue repair. The chitin-derived polysaccharide chitosan is superior than synthetic materials in several ways: it has a similar structure to the extracellular matrix, is biocompatible, biodegradable, antimicrobial, and can incorporate bioactive chemicals. In this article, check how chitosan can be used in tissue engineering as a scaffold for different types of tissue, a hydrogel for wound healing, and a carrier for gene therapy, stem cell culture, and drug delivery. Scaffolds made from chitosan have shown tremendous promise in tissue engineering for the neurological system, bone and cartilage transplantation, and skin regeneration. Hydrogels made from chitosan have been shown to be useful in treating wounds and stopping bleeding. Chitosan's medicinal potential in gene therapy, stem cell culture, and targeted medication administration is further enhanced by the addition of bioactive components such as growth factors, genes, or medicines. In addition, using chitosan in tissue engineering can pave the way for future developments in stem cell techniques, nanotechnology, biofabrication, and 3D bioprinting, among other areas of study. These advances may one day lead to individualized and highly effective therapies for tissue repair and regeneration. The use of chitosan in tissue engineering has the potential to advance regenerative medicine and address the growing demand for more effective techniques to heal damaged tissues. Tissue engineers can revolutionize the field of regenerative medicine and enhance patient outcomes by taking use of chitosan's adaptability and bioactivity to create cutting-edge biomaterials and therapeutic techniques.

Osteochondral Repair with Autologous Cartilage Transplantation with or without Bone Grafting: A Short Pilot Study in Mini-Pigs.

Treatment strategies for osteochondral defects, for which particulated autologous cartilage transplantation (PACT) is an emerging treatment strategy, aim to restore the structure and function of the hyaline cartilage. Herein, we compared the efficacy of PACT with control or human transforming growth factor-β (rhTGF-β), and clarified the necessity of bone graft (BG) with PACT to treat shallow osteochondral defects in a porcine model. Two skeletally mature male micropigs received 4 osteochondral defects in each knee. The 16 defects were randomized to (1) empty control, (2) PACT, (3) PACT with BG, or (4) rhTGF-β. Animals were euthanized after 2 months and histomorphometry, immunofluorescence analysis, semiquantitative evaluation (O'Driscoll score), and magnetic resonance observation of cartilage repair tissue (MOCART) score were performed. Hyaline cartilages, glycosaminoglycan synthesis, and collagen type II staining were more abundant in the PACT than in the control and rhTGF-β groups. The O'Driscoll score was significantly different between groups (P < 0.001), with both PACT groups showing superiority (P = 0.002). PACT had the highest score (P = 0.002), with improved restoration of subchondral bone compared with PACT with BG. The MOCART score showed significant differences between groups (P = 0.021); MOCART and O'Driscoll scores showed high correlation (r = 0.847, P < 0.001). Treatment of osteochondral defects with PACT improved tissue quality compared with that with control or rhTGF-β in a porcine model. BG, in addition to PACT, may be unnecessary for shallow osteochondral defects. Clinical Relevance. BG may not be necessary while performing PACT.

Ultrahigh-field MRI: where it really makes adifference.

Currently, two major magnetic resonance (MR) vendors provide commercial 7‑T scanners that are approved by the Food and Drug Administration (FDA) for clinical application. There is growing interest in ultrahigh-field MRI because of the improved clinical results in terms of morphological detail, as well as functional and metabolic imaging capabilities. The 7‑T systems benefit from ahigher signal-to-noise ratio, which scales supralinearly with field strength, asupralinear increase in the blood oxygenation level dependent (BOLD) contrast for functional MRI and susceptibility weighted imaging (SWI), and the chemical shift increases linearly with field strength with consequently higher spectral resolution. In multiple sclerosis (MS), 7‑T imaging enables visualization of cortical lesions, the central vein sign, and paramagnetic rim lesions, which may be beneficial for the differential diagnosis between MS and other neuroinflammatory diseases in challenging and inconclusive clinical presentations and are seen as promising biomarkers for prognosis and treatment monitoring. The recent development of high-resolution proton MR spectroscopic imaging in clinically reasonable scan times has provided new insights into tumor metabolism and tumor grading as well as into early metabolic changes that may precede inflammatory processes in MS. This technique also improves the detection of epileptogenic foci in the brain. Multi-nuclear clinical applications, such as sodium imaging, have shown great potential for the evaluation of repair tissue quality after cartilage transplantation and in the monitoring of newly developed cartilage regenerative drugs for osteoarthritis. For special clinical applications, such as SWI in MS, MR spectroscopic imaging in tumors, MS and epilepsy, and sodium imaging in cartilage repair, 7T may become anew standard.

The Promise of Regenerative Medicine in the Reconstruction of Auricular Cartilage Deformities.

There are many physiologic and psychologic challenges associated with ear cartilage deformities which are incredibly distasteful to patients, particularly children. The development of regenerative medicine (RM) sciences has opened up a new window for the reconstruction of auricular cartilage because it allows the creation of a structure similar to the auricular in appearance and function. As part of this review, we discuss the role that each RM tool, including tissue engineering, cells, and biomolecules, plays in developing engineered auricular tissue. In previous studies, it was shown that the simultaneous use of natural and synthetic biomaterials as well as three-dimensional printing techniques could improve the biological and mechanical properties of this tissue. Another critical issue is using stem cells and differentiated cartilage cells to produce tissue-specific cellular structures and extracellular matrix. Also, the importance of choosing a suitable animal model in terms of handling and care facilities, physiologic similarities to humans, and breed uniformity in the preclinical assessments have been highlighted. Then, the clinical trials registered on the clinicaltrials.gov website, and the commercialized product, called AuriNovo, have been comprehensively explained. Overall, it is important to provide engineered auricular cartilage structures with acceptable safety and efficacy compared with standard methods, autologous cartilage transplantation, and prosthetic reconstruction in RM.

Poster 238: Early Postoperative Increase of IL-1a in Synovial Fluid Correlates with Worse Short-Term Patient-Reported Outcomes after Cartilage Transplantation in the Knee

Objectives: The purpose of this study was to determine the longitudinal concentrations of several synovial fluid biomarkers after cartilage transplantation and potential correlations with patient reported outcomes. Methods: After institutional IRB approval, patients undergoing osteochondral allograft (OCA) transplantation or autochondrocyte implantation (ACI) were consented and enrolled into a prospective study involving intraoperative synovial fluid aspiration of the operative knee, as well as postoperative aspirations of the operative knee at standardized clinic follow-up timepoints: 2 weeks, 6 weeks, 6 months, and 1 year postoperatively. For this analysis, patients undergoing cartilage transplantation (OCA or ACI) with preoperative aspiration and at least one successful postoperative aspiration were included. Exclusion criteria for aspirations from the analysis included subsequent surgical procedure or articular injections on the index knee within 1 year of the transplant. The synovial fluid samples were analyzed for the following inflammatory biomarkers with Multiplex ELISA: CCL5, MMP-1, EGF, VEGF, IL1a, FGF2, CCL2, BMP2, and Aggrecan (ACAN). The samples were digested 1:1 with 3mg/mL hyaluronidase prior to execution of the assay in accordance with the manufacturer’s protocol. A minimum of 3uL was required for analysis. Patients prospectively completed Knee Injury and Osteoarthritis Outcome Score (KOOS), including Activities of Daily Living (ADL), Pain, Quality of Life (QoL), Sports, Symptoms, and Joint Replacement (JR) subscores, preoperatively and at 6 months and 1 year postoperatively. All statistical analyses were performed on RStudio and STATA. Non-parametric tests were utilized to avoid assumptions of normality. Skillings-Mack tests were utilized as a non-parametric alternative for a repeated-measures ANOVA in the setting of sporadic missing values (i.e., dry aspirations). Post-hoc pairwise Wilcoxon ranksum tests with Bonferroni corrections for multiple comparisons were performed for significant tests. Univariate linear regressions were performed to determine correlations between cytokine changes and patient-reported outcomes. A minimum of 10 observations per predictor was considered sufficient for the analysis. All testing was two-sided, and significance was set at p&lt;0.05. Results: A total of 63 aspirations from 19 patients were evaluated. Postoperatively, successful aspirations were able to be performed on 13 patients at 2 weeks (68%), 17 patients at 6 weeks (89%), 9 patients at 6 months (47%), and 5 patients at 1 year (26%) (Table 1). One patient underwent a subsequent procedure on the index knee (lysis of adhesions) 10 weeks after cartilage transplantation, thereby excluding their 6 month and 1-year aspirations from analysis. Across all timepoints, there were significant differences in MMP-1 (p=0.003), ACAN (p&lt;0.001), and FGF2 (p=0.026). Specifically, ACAN was significantly elevated at 2 (p&lt;0.001) and 6 weeks (p&lt;0.001), and MMP- 1 was the greatest at 6 weeks relative to transplant (p&lt;0.001), 6 months (p=0.01), and 1 year (p=0.04). In contrast, FGF2 was significantly lower at 2 weeks compared to transplant levels (p=0.02). There were no significant differences across timepoints for CCL5 (p=0.88), VEGF (p=0.068), CCL2 (p=0.071), BMP2 (p=0.067), IL-1a (p=0.13), or EGF (p=0.01, p&gt;0.05 for all pairwise comparisons after Bonferroni correction) (Figure 1). A subanalysis was performed for cytokines which demonstrated at least 5 “pro-inflammatory” responses (positive fold-change) and at least 5 “anti-inflammatory” responses (negative fold-change), with a minimum of 10 observations with associated patient-reported outcomes at 6 and/or 12 months postoperatively. From the 2-week aspiration samples, CCL5 (5 increase/7 decrease), IL-1a (5/7), and CCL2 (6/7) met the inclusion criteria. Increase in IL-1a demonstrated significant linear associations with worse postoperative KOOS ADL (p=0.048), Pain (p=0.01), Quality of Life (p=0.01), and Symptoms (p=0.01) scores at 6 months (Table 2, Figure 2). Similarly, an increase in CCL-2 postoperatively was associated with worse KOOS ADL (p=0.04) and Pain (p=0.04) scores at 6 months. No significant linear associations between cytokine changes at 6 weeks and later PROMs were identified. Conclusions: Following cartilage transplantation of the knee, the synovial fluid profile may demonstrate early postoperative increases in MMP-1 and ACAN and a decrease in FGF-2. An early pro-inflammatory response with IL-1a within the first two postoperative weeks may be linearly associated with worse short-term patient-reported outcomes compared to an early decrease. [Table: see text] [Table: see text]

Effect of targeted responsibility system nursing combined with psychological intervention on compliance and complications of patients with autologous nasal septum and ear cartilage transplantation.

The purpose was to explore the effect of targeted responsibility system nursing combined with psychological intervention on compliance and complications of patients with autologous nasal septum cartilage and ear cartilage transplantation filling. A retrospective analysis of the clinical data of 80 patients who underwent rhinoplasty with autologous septal cartilage and ear cartilage graft filling was conducted. Patients before the implementation of the "targeted accountable care combined with psychological intervention" program from January 2020 to December 2020 were set up as the control group (N.=40), and patients after the implementation of the program from January 2021 to December 2021 were set up as the study group (N.=40). The Hamilton Anxiety Scale (HAMA), Lund-Kennedy Endoscopy Score, Hamilton Depression Scale (HAMD), treatment compliance, and complications were compared between the two groups. At two weeks postoperatively, HAMA and HAMD were lower in the study group than in the control group (t=9.087, 9.265, P<0.05), and bilateral Lund-Kennedy scores were lower in the study group than in the control group (t=8.761, 10.267, P<0.05). The study group had a higher compliance excellence rate (75.00% vs. 52.50%) than the control group (χ2=4.021, P<0.05) and a lower complication rate (7.50% vs. 27.50%) than the control group (χ2=4.242, P<0.05). Targeted accountable care combined with psychological intervention can alleviate negative emotions in patients with nasal septum cartilage and ear cartilage graft filling, reduce the risk of postoperative soft tissue edema and other complications, and improve patient compliance with treatment.

A comparison of autologous auricular cartilage transplantation and prosthetic material transplantation of rhinoplasty patients.

A comparison of autologous auricular cartilage transplantation and prosthetic material transplantation of rhinoplasty patients.