Preprint Brief Report Version 2 Preserved in Portico This version is not peer-reviewed

Wharton’s Jelly Tissue Allograft for Connective Tissue Defects Surrounding Nerves in the Tarsal Tunnel: A Retrospective Case Series

Version 1 : Received: 16 November 2023 / Approved: 20 November 2023 / Online: 20 November 2023 (03:36:52 CET)
Version 2 : Received: 18 January 2024 / Approved: 19 January 2024 / Online: 19 January 2024 (07:54:24 CET)

A peer-reviewed article of this Preprint also exists.

Bruton, R.; Gilliland, T.L.; Shou, J.J.; Woods, C.G.; Lambert, N.E.; Barrett, T.C. Wharton’s Jelly Tissue Allograft for Connective Tissue Defects Surrounding Nerves in the Tarsal Tunnel: A Retrospective Case Series. Reports 2024, 7, 8. https://doi.org/10.3390/reports7010008 Bruton, R.; Gilliland, T.L.; Shou, J.J.; Woods, C.G.; Lambert, N.E.; Barrett, T.C. Wharton’s Jelly Tissue Allograft for Connective Tissue Defects Surrounding Nerves in the Tarsal Tunnel: A Retrospective Case Series. Reports 2024, 7, 8. https://doi.org/10.3390/reports7010008

Abstract

Caused by age or trauma, collapsed connective tissue can cause nerve entrapment and damage within the tarsal tunnel. Tarsal tunnel syndrome is relatively underdiagnosed. This study presents an intervention targeting damaged tissues surrounding the nerves and replacing the structural cushioning with a Wharton’s jelly tissue allograft. The eight selected patients from four clinical sites had tarsal tunnel-related defects. Patient outcomes were tracked on a 90-day calendar utilizing the Numeric Pain Rating Scale (NPRS) and the Western Ontario and McMaster University Arthritis Index (WOMAC). All patients had failed standard care practices for at least six weeks. Each patient received a Wharton’s jelly tissue allograft to sites around the affected tarsal tunnel. No patients experienced adverse reactions. Percent change calculated from the initial application to the 90-day follow-up showed an improvement of 59.43% in NPRS and a 37.58% improvement in WOMAC. This study provides evidence that WJ allograft applications are safe, minimally invasive, and efficacious for patients who have failed standard care treatments for tissue defects associated with Tarsal Tunnel syndrome. Limitations include the small cohort size and nonblinded nature. The results of this study warrant further research to confirm the efficacy, optimal dose, protocol, and durability of Wharton's jelly.

Keywords

tarsal tunnel; nerve damage; neuropathy; wharton’s jelly; regenerative medicine

Subject

Medicine and Pharmacology, Clinical Medicine

Comments (1)

Comment 1
Received: 19 January 2024
Commenter: Naomi Lambert
Commenter's Conflict of Interests: Author
Comment: This paper is under review for publication in a journal and has received comments and edits reflected in this update.
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