# Wharton’s Jelly Tissue Allografts for Tearing in the Plantar Fascia: A Case Series

## TL;DR

This case series explores using Wharton’s jelly allografts to treat plantar fasciopathy, showing potential safety and effectiveness in reducing heel pain.

## Contribution

The study introduces Wharton’s jelly allografts as a novel conservative treatment for plantar fasciopathy with observed clinical improvements.

## Key findings

- Patients showed overall improvement in pain and quality-of-life scales over 90 days.
- Statistically significant changes were observed in the WOMAC scale after Bonferroni adjustment.
- Age was a significant predictor of WOMAC score improvement.

## Abstract

Introduction: Plantar fasciitis (PF), or more recently plantar fasciopathy due to its degenerative nature, is the most common cause of heel pain in adults and is often refractory to conservative care. One alternative conservative intervention involves replacing damaged fascia with homologous tissue, such as Wharton’s jelly (WJ) connective tissue allografts. The purpose of this observational study is to evaluate the efficacy and safety of collagen-rich Wharton’s jelly (WJ) when applied to defects in the plantar fascia. Materials and Methods: From the observational repository, nine patients who had plantar fasciopathy and received a single application of WJ were observed over 90 days. Outcomes were tracked using the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster University Arthritis Index (WOMAC), and the Quality-of-Life Scale (QOLS) with no adverse reactions reported. Results: The cohort was 56% male (n = 5) and 44% female (n = 4), with a mean age of 73. From the initial to final visit, patients reported an overall trend of improvement in all scales. Statistically significant Bonferroni-adjusted differences were observed in the WOMAC scale. Age was a significant predictor of the total WOMAC score change from the initial to the final visit. Discussion: Although only a small cohort was observed, the preliminary evidence suggests the safety and efficacy of WJ allografts for plantar fascia degeneration. Key limitations of this study included a small cohort size and a lack of a comparison group with other alternative methods. Conclusions: The favorable results in this study could encourage future research to validate the clinical potential, safety, and dosing protocols of Wharton’s jelly as a primary conservative care method for patients suffering from plantar fasciopathy.