Intraosseous Injection - The BIOS Orthopedic Institute

The BIOS Orthopedic Institute

Alberto J. Panero, D.O.

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

While the cartilage at articular surface of the joint has always been the primary focus of arthritis treatments, recent studies continue to highlight the importance of treating the bone underneath. This area, referred as the “subchondral bone”, bone underneath the cartilage can become inflamed and diseased. This bone inflammation is called subchondral edema, and because it increases the pressure inside of the bone, it can be quite painful. Furthermore, it sets a negative inflammatory cycle with the cartilage below it, leading to further breakdown of the joint.

With the advent of orthobiologics and interventional orthopedics, we can now treat the subchondral bone by performing intraosseous injections. Sometimes we have to use a bioactive scaffold like demineralized bone matrix (DBM) to help the bone heal.

There are now studies that show that by treating the subchondral bone along with the cartilage can slow down the progression of arthritis, and prevent the need for joint replacement.

At one of the visit, we will also perform an intra-osseous injection in to the site of bony pathology under x-ray guidance.

This injection can be painful while its happening, but quickly resolves after the injection is over. We protect the area by modifying your weight bearing for 5-7 days afterwards, and typically recommend using a compartment unloader brace for 4-6 weeks after the injection to help with healing.

Initial consultation went well. Looking forward to the next few appts to get back to total health.

Andy W.

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.

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.

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.

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.