Viability of crushed and diced cartilage grafts wrapped in oxidized regenerated cellulose and esterified hyaluronic acid: an experimental study.

Objectives: The objective of this study was to investigate the viability of diced/crushed cartilage grafts wrapped in esterified hyaluronic acid (HYAFF) and oxidized regenerated cellulose (Surgicel) with respect to macroscopic and microscopic parameters.

Study Design: Experimental study.

Methods: A total of 10 New Zealand rabbits were acquired for the study. Cartilage grafts were harvested from both ears, with the ventral and dorsal perichondrial layers dissected off. There were six comparison groups in this experimental study: 1) bare, diced cartilage, 2) diced cartilage wrapped in Surgicel, 3) diced cartilage wrapped in HYAFF, 4) bare, crushed cartilage, 5) crushed cartilage wrapped in Surgicel, 6) crushed cartilage wrapped in HYAFF. Six cartilage grafts were inserted into the six subcutaneous pockets of the same animal. All the rabbits were sacrificed at the end of 2 months, the samples were collected, and the total specimen was examined histopathologically. The sections were stained with hematoxylin-eosin and Masson trichrome stain and examined under light microscopy.

Results: There was a significant difference among the bare, diced cartilage, the Surgicel, and the HYAFF groups with respect to fibrosis, chronic inflammation, cartilage mass, and vascularization. A significant difference was observed among the bare, crushed cartilage, Surgicel, and HYAFF groups with respect to fibrosis, chronic inflammation, and cartilage mass. There was no significant difference among the three groups regarding vascularization.

Conclusions: This study suggests that wrapping cartilage grafts with Surgicel grossly reduces cartilage viability and the regeneration potential of the chondrocytes, leading to fibrosis formation. On the other hand, hyaluronic acid promotes cartilage integrity and survival, thus increasing clinical predictability and avoiding the need for overcorrection.