The BIOS Orthopedic Institute

Alberto J. Panero, D.O.

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

Stem cell therapy is a cornerstone of regenerative orthopedics. Stem cells are used to stimulate tissue repair and growth in your body. Visit The BIOS Orthopedic Institute in Sacramento, California, to learn how Dr. Alberto J. Panero can apply this leading-edge therapy to bring relief to your soft tissue injuries and get you fully functional and healthier than ever.

What type of “Stem Cells” repair the musculoskeletal system?

There are different type of stem cells in the body. At BIOS we focus on harvesting and concentrating adult, “mesenchymal stem cells (MSC’S)”. These cells are pericytes, and are found in nearly all tissues throughout the body. They are the known repair cells of the musculoskeletal system, specializing in repairing bone, cartilage, muscle, tendon, and ligament.

How do mesenchymal “stem cells” work in orthopedics?

There are three main proposed mechanisms of action; tissue repair directly or via paracrine signaling, engraftment, and immune modulation. These properties make them ideal for the treatment of arthritis, tendon, muscle, and ligament injuries.

Although, in vitro (in the lab) mesenchymal stem cells may show the ability to differentiate into a desired tissue type, it is debatable if the MSC’s that are being transplanted into patients are differentiating into the desired host tissue type. Instead, current research support that MSC’s release trophic and immunomodulatory factors that activate and manage the body’s innate healing response. In view of this, describing them as “medicinal signaling cells MSC’c” may be better served.

These properties can be used differently in distinctive pathologies respective to their pathological stage. In an early arthritic joint, the response to an injection may be enough to change the micro-environment and induce meaningful signaling to halt the osteoarthritic disease and/or heal the injury to the cartilage, while in and end-stage arthritic joint, it may only help with pain and inflammation but not alter the disease (restore joint space, grow cartilage, remove bone spurs). Correspondingly, an injection of these products into a small, contained, partial tendon tear may be able to provide enough of a response for the tenocytes to proliferate and heal the tear, while it may have no effect on a full thickness, retracted tear.

How are stem cells harvested from your bone marrow?

Bone marrow is aspirated from the back of your hip. This procedure is well tolerated because the back of your hip is precisely anesthetized under ultrasound guidance with a long acting anesthetic.  Once the bone marrow is collected, it’s filtered through a machine, centrifuged and separated.

How are stem cells harvested from fat?

Fat’s collected from the belly, flank, or thigh. After receiving local anesthesia, the doctor inserts a thin tube to collect the adipose tissue, which is then put in a cylinder and “shaken.” Shaking separates the cells from the fat tissue and the stress of this agitation may activate them to start tissue repair.

How long is recovery from the harvesting process?

Both procedures take 30 minutes and you go home the day of the procedure. Complete healing of bruising, swelling, and soreness will take about 1- 2 weeks.

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.

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 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.

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.