Lab-grown cartilage, PRP, 3D printing: what is still experimental

Cartilage grown from the patient’s own cells is interposed, then covered by mucosa.

First described by : Kaiser, Fulco, Vavrina, Schaefer, Martin, Barbero and Haug, Int J Surg 2024, for the Basel phase I trial (NCT04633928) on autologous nasal tissue-engineered cartilage (N-TEC).

The idea is to manufacture the missing tissue rather than move it. In the Basel trial, chondrocytes are taken from the patient's septum, multiplied in the laboratory, then cultured in three dimensions in a collagen membrane. The resulting graft is wrapped in temporal fascia, placed as a sandwich in the perforation, and the mucosa grows back over it under splints for six weeks. Around that main route, several adjuncts are being tested: platelet-rich plasma, growth factors, resorbable 3D-printed meshes, stem cells. None has shown efficacy: these are trials, not routine care options.

1. 1Harvest of a small fragment of septal cartilage under local anaesthetic.
2. 2Expansion of the chondrocytes in a pharmaceutical-grade (GMP) facility, using human platelet lysate instead of the patient's serum.
3. 3Three-dimensional culture over several weeks in a collagen membrane, until a cartilage graft the size of the defect is obtained.
4. 4Surgery: the graft, wrapped in temporal fascia, is interposed in the perforation as a sandwich.
5. 5Silastic splints for six weeks while the mucosa covers the graft; close follow-up required by the trial protocol.

Named variants

• Patients eligible for a clinical trial, in a centre running one.
• Perforations of 0.5 to 2 cm, the scope of the phase I trial.
• Patients who accept a research protocol: constraints, visits, uncertainty about the result.
• Situations where any further tissue harvest inside the nose should be avoided.
• Patients informed that making the graft takes several weeks before surgery.

• Any expectation of a guaranteed result: efficacy is not established, only a feasibility trial exists.
• Perforations that a proven technique can close with over 90% success in an expert centre.
• Patients who could not be followed up at the investigating centre.
• Commercial offers of PRP or stem cells outside a trial, at your expense: no data support them.
• Total or subtotal perforations: outside the scope studied.

Published results

• Efficacy not established: a phase I trial measures feasibility and safety, not closure rates.
• Several weeks between the cell harvest and the operation.
• Very limited availability: a handful of centres, within a protocol.
• Adjuncts (PRP, stem cells) sometimes offered outside trials and charged for, without evidence.
• No long-term data: how lab-grown cartilage holds beyond a few months is unknown.

1. 1Is there an open trial I could join, and where?
2. 2Who funds the operation and the follow-up within the trial?
3. 3What happens if the engineered graft does not take: what options remain?
4. 4Does this cartilage harvest compromise a conventional technique later?
5. 5If you offer me PRP or stem cells outside a trial, what data are you relying on?

Write the answers down: they are what lets you compare two opinions.

Where it is done

Related techniques