Chondrocytes versus chondroprogenitors for auricular cartilage repair: a critical comparative review

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Abstract
Background: Auricular cartilage defects, whether congenital or acquired, present a significant reconstructive challenge. Autologous chondrocytes implantation remains the clinical gold standard but is limited by donor-site morbidity, limited cell availability, and dedifferentiation during expansion. Cartilage stem/progenitor cells (CSPCs) have emerged as a promising alternative, yet their comparative properties remain underexplored. Methods: A comprehensive literature review was conducted across PubMed, MEDLINE, Cochrane, and Web of Science databases up to 2026, utilizing keywords such as chondrocytes, chondroprogenitors, Cartilage stem/progenitor cells, CSPCs, auricular cartilage, ear reconstruction and tissue engineering. Results: Chondrocytes exhibit robust matrix synthesis but suffer from dedifferentiation and limited proliferation. CSPCs demonstrate superior self-renewal and immunomodulatory properties, yet face challenges of hypertrophic differentiation and inferior tissue elasticity. Co-culture and scaffold-based strategies have been employed to enhance the functionality of both cell types in engineered constructs. Conclusion: Both chondrocytes and CSPCs present distinct advantages and limitations for auricular cartilage repair. Future strategies should aim to combine their strengths, such as the functional specificity of chondrocytes and the expandability of CSPCs, to develop more effective and clinically feasible tissue-engineered constructs for ear reconstruction.

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