Construction of three-dimensional cartilage autograft and evaluation of the superiority of interperichondrial implantation

Aims: This study aimed to develop a three-dimensional (3D) cartilage autograft using diced cartilage and fibrin tissue glue and to compare the outcomes of interperichondrial implantation versus subcutaneous implantation in terms of graft viability, biomechanical properties, and histopathological characteristics. Methods: Eleven albino rabbits underwent auricular cartilage harvesting, with a 3 × 2 cm segment dissected bilaterally. After dicing, the cartilage fragments were combined with fibrin tissue glue and molded into two 3D dorsal nasal grafts. One graft was implanted into the interperichondrial pocket of the right ear, and the other was placed subcutaneously in the right dorsal region. Two control sites were created: subcutaneous fibrin-only implantation on the left dorsal region and an empty interperichondrial pocket on the left ear. The rabbits were sacrificed at eight weeks, and the grafts were evaluated macroscopically, physically, and histopathologically. Results: Two animals were excluded due to graft loss from flap necrosis. In the remaining rabbits, the interperichondrial group exhibited superior shape retention, less volume loss, and higher elasticity compared to the subcutaneous group (p < 0.05). Histopathological assessment showed significantly greater chondrocyte viability (p < 0.05) and new cartilage formation (p < 0.05) in the interperichondrial group, coupled with lower vascularization (p < 0.05) and reduced fibrosis (p < 0.05). By contrast, the subcutaneous group exhibited prominent vascularization, dense fibrous encapsulation, and more pronounced shape and volume loss. No significant intergroup differences were observed for fibrin residue or ossification (p > 0.05). The control grafts (fibrin-only and empty interperichondrial sites) demonstrated no cartilage formation. Conclusion: Diced cartilage grafts combined with fibrin tissue glue are better supported in the interperichondrial environment than in the subcutaneous tissue. Interperichondrial implantation not only preserves graft shape and volume but also enhances chondrocyte viability and cartilage regeneration, emphasizing its potential as a clinically valuable strategy in reconstructive cartilage grafting.