The BIOS Orthopedic Institute

Alberto J. Panero, D.O.

Regenerative Orthopedics Specialist & Sports Medicine Specialist located in Sacramento, CA

Osteoarthritis, in which the cartilage and other connective tissue at joints wears down over time, can lead to progressive pain and limit range of motion. Don’t let this issue keep you from doing the activities you love. Visit Dr. Alberto J. Panero of The BIOS Orthopedic Institute in Sacramento, California, for state-of-the-art treatments that capitalize on your body’s natural healing capabilities.

How do I know if I have arthritis?

A consultation and exam will help you know for sure, but you may suspect arthritis if you experience:

  • Sore or stiff joints
  • Limits to your range of motion
  • Clicking or cracking sounds at affected joints
  • Mild swelling
  • Pain that worsens following activity

Joints that are typically affected include your knees, hips, shoulders and elbows. Arthritis pain usually increases over time.

What treatments are available at BIOS?

1.Viscosupplementation Injections- gel-like injections of hyaluronic acid that attempt to lubricate the joint, decrease inflammation, and coat exposed nerve endings. Therapy varies per insurance coverage and can be a one-time injection vs. a series of 3 injections once per week. No longer covered by many insurances. May be covered by insurance, with pre-authorization. Self-pay costs $100 per injection.

2.Platelet Rich Plasma (PRP) Injections – blood is taken from your arm and is centrifuged to concentrate platelets and remove white and red blood cells. The goal is for platelets to release growth factors and cytokines that promote an anti-inflammatory effect, reduce pain, and stimulate healing. There is also the potential for joint preservation by slowing down arthritic process. Although one injection may help, studies support a series of 3 injections, 1 x Week/3weeks, the first is highly concentrated, followed by two booster injections. Not covered by insurance.

Self-pay costs: One injection – $875. Series of three injections – $2,150
Bilateral same body part – Two Injections -$1200. Series of six injections – $3,600

3.Bone Marrow Concentrate “Stem Cell” Injections – bone marrow is aspirated from the back of your pelvis and centrifuged in a special kit to concentrate “stem cells”, growth factors and cytokines, which are then re-injected into the joint and/or bone. The goals are to change the living micro-environment of the joint to a positive one, and to decrease inflammation and cartilage cell death. Will promote healing of cartilage, will not re-grow cartilage, restore joint space, or remove bone spurs. There is also great potential for joint preservation by slowing down the arthritic process in early stages. Not covered by insurance. Self-pay costs $3800 per injection.

4.Intra-Osseous Injections – newer literature suggests that treating the subchondral bone (bone underneath cartilage) is just as important as the cartilage/joint. This is recommended when the bone shows inflammation or edema, or in the setting of “bone on bone” arthritis. A small needle is advanced into the bone precisely under x-ray guidance. PRP or Bone Marrow concentrate is then injected into the bone. Bone Marrow Concentrate is preferred. Not covered by insurance. Self pay costs – an additional $1,000 to either original procedure.

5.The Works Package: A series of 1 Bone Marrow Concentrate “stem cell” injection into the joint and intra-osseous, 2 PRP & 3 hyaluronic acid joint injections into the joint. $5,750 ($700 discount).

Very personable and knowledgeable presenting options for the problem and then going forward from the choice made. I would definitely recommend him to friends and family! Office staff is fabulous as well.

Jim M.

I really appreciate Dr. Panero’s skill and expertise, as well as his focus, deep active listening, and clear communication about next steps. Thank you so much!

Susan C.

I was very happy with Dr. Panero. He took his time to listen to me and evaluate me. Then he went over all my options and answered all my questions. I am very glad I was referred to him!

David M.

Dr. Panero is an amazing physician who truly cares about the wellbeing of his patients. His entire team is dedicated, thorough, and professional who makes sure all appointments go smoothly even with the ongoing pandemic. Dr. Panero recommended PRP for my elbow tendinitis and truly advocated for me to get the treatment I needed to improve my chronic pain. I am so grateful to be one of Dr. Panero’s patients!

Rena S.

Finally after 3 months of being brushed off, I found a Doctor who cared to take an extra minute to treat me as an individual and listen. I saw several doctors without a diagnosis and I now have that and a plan of care. Truly grateful for Dr . Panero!!! Very Thorough.

Davina R.