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).

I just had my first visit with Dr. Panero and found him to be knowledgeable and personable. I appreciate the fact that he was straightforward with my options for treatment, which are limited due to the nature of my orthopedic problem. I will continue with his recommended injections.

Karen L.

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.

Dr. Panero is extremely professional and takes the time to explain in detail his diagnosis and opinion. He is also willing to listen to your concerns and needs.(Some orthopedic doctors I’ve meet with have not been as open minded.) I really like his approach to rehab and regeneration. It is refreshing to not have a Dr. want to immediately operate or medicate you. Nice courteous staff, reasonable wait time and the office is very accessible with a parking garage. Parking fee, I paid $1 for 30 mins, cash only.

Ronald Z.

Dr Panero is superb. Always and I have unqualified respect and admiration and trust in him. I am fortunate to be a patient and client of his. His staff are excellent and so professional and thoughtful too.

Leslie S.

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.