The role of costal cartilage in musculoskeletal regeneration: A systematic review

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Purpose Musculoskeletal tissue regeneration remains a major clinical challenge due to the limited intrinsic healing capacity of cartilage, bone and interface tissues, as well as the complexity of recreating their hierarchical structure and mechanical properties. In recent years, costal cartilage (CC) has emerged as a promising and versatile resource for regenerative applications, owing to its hyaline cartilage composition, biological plasticity and relative surgical accessibility. This systematic review aims to critically evaluate in vivo and clinical evidence published over the last decade regarding the use of CC-derived cells and matrices for musculoskeletal tissue regeneration. Methods A systematic search of PubMed, Scopus and Web of Science databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying 26 eligible studies, including 18 in vivo and 8 clinical investigations. Results CC was employed either as a source of costal chondrocytes or cartilage-derived stem cells, or as decellularized or particulate extracellular matrix scaffolds. Preclinical studies demonstrated consistent regenerative potential across cartilage, osteochondral, bone and enthesis models, with outcomes showing hyaline-like tissue formation, improved biomechanical properties, enhanced integration with host tissue and coordinated cho

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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