Intraosseous Injections

What are Intraosseous (IO) injections?

Intraosseous (IO) injections are the most advanced minimally invasive treatments offered at the Orthohealing Center. They are considered for bone pathologies resulting from acute or chronic injury, including severe arthritis, bone marrow lesions associated with insufficiency fractures, persistent bone bruises, and early stages of avascular necrosis.

By delivering platelet-rich plasma and / or bone marrow concentrate under the cartilage, just below the joint surface into bone, IO injections may stimulate and enhance healing.

In most cases, bone marrow aspirate, PRP, or other regenerative medicine substances are simply delivered into the joint space where the patient is experiencing issues and / or pain. But when severe cartilage wear and / or bone degeneration presents in areas with poor blood supply, addressing only this environment is insufficient. Intraosseous injections have the potential to stimulate the body’s natural healing process and alter dysfunctional cell signaling by reaching damaged regions deep below the joint’s surface.

What are the benefits of IO injections?

This technique offers a less invasive, more natural approach to nourish and heal degenerative joints than do traditional medical interventions. With previously limited treatment options available, it also provides hope to severe arthritis sufferers. IO injections appeal to those who want to avoid the increased risk, downtime, and recovery time associated with surgery. As with all the Orthohealing Center’s procedures, this modality is safely delivered on an outpatient basis; conversely, traditional knee and hip replacements require hospital stays. Furthermore, due to the finite nature of joint replacements, there are few alternatives available should the surgical approach fail; as an added benefit, IO injections do not exhaust any treatment options.

What conditions does IO therapy treat?

IO is considered for severe arthritis, to address the associated pain, limited function, and small cracks in the bones beneath the cartilage. These microfractures are indicated in MRI imaging by bright white regions (edema). Additionally, the presence of bone-swelling on MRI signifies the progressive advancement of arthritis. IO injections may decrease the likelihood of total joint replacement surgery for patients diagnosed with severe arthritis.

Why choose the Orthohealing Center for IO procedures?

Our esteemed physicians were among the first in the world to treat patients with Intraosseous (IO) injections. They have conducted extensive research on the approach and have also authored a textbook on the subject. Additionally, the Orthohealing Center’s team has shared and advanced their IO techniques at the Walter Reed National Military Medical Center, and at medical conferences and symposiums around the globe.

Furthermore, our doctors use advanced x-ray guidance for the precise delivery of each injection to maximize patient comfort and treatment outcomes.

Are IO injections painful?

Although IO injections can be performed in-office with local anesthetic and nitrous oxide, they are generally administered with twilight sedation at an outpatient surgery center to optimize patient comfort during the procedure.

Recovery after IO injections

Recovery times vary based on the area treated, patient compliance, and severity of the damage. Most individuals only experience discomfort for two to three days post-procedure. Many experience pain relief immediately after IO therapy, as injecting directly into the bone can reduce the accumulated pressure. When this innovative approach is applied on knees, for example, there is no need for crutches; patients can bear weight as tolerated.

Are IO injections suitable for everyone?

This approach is typically appropriate for those:

  • with severe osteoarthritis with or without bone marrow edema lesions
  • with localized pain corresponding with their MRI
  • who would like to avoid joint replacement surgery
  • for whom more traditional methods of treatment of failed
  • who are not candidates for surgery

Factors for consideration include age, activity level, weight, and the underlying medical issue.

What other therapies address bone damage?

As an alternative or adjunct to IO injections, Focal Shockwave may be used to reduce bone edema and strengthen bone.

Will this treatment stimulate the regrowth of cartilage?

Although we commonly see improvement of bone edema on MRI post-IO injection procedure, surgery is typically required for cartilage regeneration of focal lesions.

Important IO articles

Regenerative Medicine to Keep You Moving