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This review presents the major evidence on the properties of costal cartilage and bone and their qualifications as grafts for articular cartilage repair, the major clinical applications, and the risks and strategies for costal chondral\/osteochondral graft(s) harvest. First, costal cartilage has many specific properties that help restore the articular surface. Costa, which can provide abundant cartilage and cylindrical corticocancellous bone, preserves permanent chondrocyte and is the largest source of hyaline cartilage. Second, in the past three decades, autologous costal cartilage\u2010derived grafts, including cartilage, osteochondral graft(s), and chondrocyte, have expanded their indications in trauma and orthopaedic therapy from small to large joints, from the upper to lower limbs, and from non\u2010weight\u2010bearing to weight\u2010bearing joints. Third, the rate of donor\u2010site complications of ACCT or ACOT is low, acceptable, and controllable, and some skills and accumulated experience can help reduce the risks of ACCT and ACOT. Costal cartilage\u2010derived autografting is a promising technique and could be an ideal option for articular chondral lesions with or without subchondral cysts. More high\u2010quality clinical studies are urgently needed to help us further understand the clinical value of such technologies.<\/jats:p>","DOI":"10.1111\/os.13992","type":"journal-article","created":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T03:19:15Z","timestamp":1706239155000},"page":"523-531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Autologous Costal Chondral\/Osteochondral Transplantation and Costa\u2010Derived Chondrocyte Implantation for Articular Cartilage Repair: Basic Science and Clinical Applications"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-6834","authenticated-orcid":false,"given":"Yuxuan","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University  Guangzhou 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