The rate of warping in irradiated and nonirradiated homograft rib cartilage: A controlled comparison and clinical implications

Irradiated homograft costal cartilage reportedly warps less than autologous cartilage based on clinical observation; however, no controlled, experimen tal studies on the warping characteristics of irradiated homograft costal c artilage have been done. Fresh cadaver costal cartilage (ribs 5 through 8) was prepared and irradiated using a standardized technique. A specially des igned cartilage-cutting device was used to cut the cartilage into a reprodu cible size. The irradiated (n = 23) and nonirradiated (n = 20) groups were incubated in vitro and assessed over a 4-week period. Ther-e was no signifi cant difference in warping between the irradiated and nonirradiated groups (p = 0.1). The centrally cut pieces of cartilage in each group warped less than peripherally cut blocks in each group. Peripherally cut pieces of both the irradiated and nonirradiated groups warped at a faster rate compared w ith the nonirradiated groups. All cartilage exhibited continued warping ove r the 4-week study period. We concluded that there was no difference in war ping characteristics between irradiated and nonirradiated homograft rib car tilage. Furthermore, unlike previous studies, cartilage grafts continued wa rping over time for at least 4 weeks, and this phenomenon may be extrapolat ed as a causative factor in delayed postoperative nasal deviation after rhi noplasty and nasal reconstruction where rib grafts are used.