The Effect of Platelet-Rich Fibrin on Block, Crushed and Diced Cartilage

Abstract

Background: In nasal surgery, autologous cartilage grafts are routinely used to correct structural weakness, contour deformities, and irregularities, yet current techniques still face challenges related to long-term cartilage graft viability and resorption. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that may improve graft survival through its sustained release of bioactive molecules within a natural fibrin matrix.

Objective: To evaluate the biochemical and histopathological effects of combining PRF with autologous cartilage grafts of different forms (block, crushed, and diced) in a rabbit model and to determine which combination provides optimal cartilage viability and matrix stability.

Methods: Twenty-four New Zealand rabbits divided into six groups based on their form: block, crushed, and diced. PRF was applied to three groups, while the remaining three served as controls. The grafts were placed in subcutaneous pockets on the rabbits' backs and harvested after 8 weeks for histopathological and biochemical analyses. Cartilage tissues, growth factors, matrix components, angiogenesis, oxidative stress, and apoptosis markers were evaluated.

Results: PRF-treated groups demonstrated significantly higher growth factor levels, antioxidant status, lower oxidative stress and apoptosis markers compared with controls (p < 0.05). Histological analyses showed better cellular proliferation and extracellular matrix preservation, particularly in PRF-combined diced and block cartilage grafts, whereas crushed cartilage exhibited marked degeneration.

Conclusion: PRF enhanced the viability, proliferation, and angiogenic response of autologous cartilage grafts through its sustained release of growth factors and scaffold-like fibrin matrix. These findings suggest that PRF may improve graft stability and reduce postoperative complications in nasal surgery.

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Abstract as indexed by PubMed; the article is open access (PubMed Central).