Wharton’s Jelly Allografts for Intra-Articular Cartilage Degeneration in the Ankle

Introduction: Despite its lower prevalence, ankle osteoarthritis is equally debilitating as the more commonly known types of osteoarthritis. The high complication rate for surgical intervention necessitates the need for more efficacious, conservative methods in standard care. Wharton’s jelly (WJ) possesses components similar to the intra-articular cartilage that can supplement and repair musculoskeletal defects. The objective of this study is to report positive exploratory findings from patient-reported scales after WJ applications to structural defects in patients with treatment-resistant ankle osteoarthritis. Materials and Methods: Thirty patients with intra-articular cartilage degeneration in the ankle who failed at least three months of current conservative care were identified from an observational repository. The assessment of patient-reported results was conducted using the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster University Arthritis Index (WOMAC), and the Quality of Life Scale (QOLS). WJ tissue allografts were applied to the specified affected site in the ankle. No adverse events were reported. Patients were categorized into three groups based on the total application amount. Results: The percent improvement was calculated from the initial to the final visit, depending on the number of applications. Each application category displayed improvement. A correlation was observed between the level of overall improvement and the number of applications. Discussion: This study confirms current literature suggesting WJ is safe, minimally invasive, and beneficial to patients with intra-articular cartilage degeneration. Limitations addressed in this study include a small sample size, no control group, and the use of a generalized assessment scale. Conclusion: The results of this study warrant further research to establish the best practice protocols for Wharton’s jelly in patients suffering from structural degeneration caused by ankle osteoarthritis.