Connective tissue defects at tendon and ligament insertions are common among adults, and Achilles tendinosis is one of the most frequent enthesopathies. This case report describes the application of Wharton’s jelly (WJ) to supplement tissue defects at the Achilles tendon and its insertion.
The patient was a 54-year-old female with slow-onset chronic Achilles tendinosis and retrocalcaneal exostosis that progressively worsened over three years despite standard-care treatments, including rest and two prior surgical procedures on the contralateral foot.
Clinical Significance:
The patient reported severe baseline pain (10/10 VAS). By week 13, pain decreased to 0/10 VAS, accompanied by improved function. These observations support continued research on multimodal protocols using Wharton’s jelly, EPAT, and class IV laser therapy in cases unresponsive to standard care.
A Step Toward Evidence-Based Care:
The improvement observed in this case highlights the need for future studies to evaluate safety, efficacy, and the optimal allograft size (in milligrams) when combining Wharton’s jelly with EPAT and laser therapy for Achilles tendinosis and other enthesopathies.