Wharton’s Jelly Allografts for Micro Tearing of the Posterior Tibial Tendon

Introduction: Posterior tibial tendon dysfunction (PTTD) is a specific form of enthesopathy characterized by progressive degeneration and dysfunction of the posterior tibial tendon, often presenting with inflammation, tendon thickening, and pain along the foot. Current standard-of-care procedures produce many risks and complications, especially in operative care, highlighting the need for a favorable alternative medicine. Wharton’s jelly (WJ) possesses a collagen-rich matrix similar to tendons that can supplement tendon defects. This study aims to report supportive preliminary findings from patient-reported scales after WJ applications to patients with PTTD refractory to standard care. Materials and Methods: Twenty-six patients from the observational repository were identified with posterior tibial tendon defects who failed three months of conservative care. Patients received either a single application or two sequential applications based on the severity of their condition. The patient-reported results utilized 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 structural defects in the posterior tibial tendon. No adverse events were reported. Results: Patients were categorized according to the number of applications they received. The percent improvement of each category was calculated from their initial visit to their final visit. Each dosage category observed improvement. Discussion: This study confirms that the application of WJ tissue allografts in treatment-resistant PTTD is beneficial, safe, and minimally invasive, providing preliminary evidence for utilizing WJ as an alternative method to current standard practices. Several limitations in this study included the lack of direct comparison groups with other conventional interventions and recall bias. Conclusion: The positive findings of this study indicate the need for further research to establish the best dosage protocols for Wharton’s jelly in patients suffering from PTTD.