Intraosseous Injections

Intraosseous or (IO) injections, involve injecting Platelet Rich Plasma and/or Bone Marrow Concentrate into bone.

When arthritis is severe, the bone beneath cartilage causes pain and limited function (1). These bones develop small cracks or micro fractures easily seen on MRI lighting up as edema. IO is considered for severe arthritis and is the most advanced minimally invasive option at Orthohealing.

image002
image004

Image courtesy of Henning Madry, Homburg Germany

The edema (bright white regions) suggests bone weakness “like pouring water on wood.”

Bone edema on MRI correlates with pain more than cartilage loss on X-ray or the amount of excessive joint fluid. (1) Bone edema indicates that the arthritis is actively advancing, and patients are much more likely to require a total knee replacementwithout intervention.

Why Orthohealing for IO Procedures?

The Orthohealing team are among the first in the world to implement IO injections and have published research and a textbook on the procedure. We have visited fellow Pioneering physicians including Mikel Sanchez and Nicholas Fiz in Spain and hosted Phillipe Hernigou (France) to our annual TOBI conference with cadaver labs and lectured at many international symposiums including Walter Reed National Military Medical Center on our IO techniques.

image001 7

FAQ

Does it hurt?

Most often IO injections are performed with twilight sedation at an outpatient surgery center. On occasion, it can also be performed in office with Nitrous Oxide and local anesthetic.

What is the recovery like?

For most areas up to 48-72 hours of increased discomfort can be expected. However, injecting into bone can reduce the pressure built up inside bone, providing some temporary relief while the healing takes more time. For knee procedures, patients may weight bear as tolerated and crutches are not required.

What equipment is used?

Patients with severe osteoarthritis with or without bone marrow edema lesions and localized pain corresponding with their MRI. Patients typically have failed conservative measures and would like to avoid or are not ideal candidates (age, activity level, weight, or underlying medical problems) for jointreplacement.

image010
image008

What type of patients are typically candidates for IO?

Patients with severe osteoarthritis with or without bone marrow edema lesions and localized pain corresponding with their MRI. Patients typically have failed conservative measures and would like to avoid or are not ideal candidates (age, activity level, weight, or underlying medical problems) for jointreplacement.

What other treatments can stimulate bone?

As an alternative or adjunct to IO:Focal Shockwave may be used to reduce bone edema and strengthen bone (8,9,10).

Will this treatment regrow cartilage?

No. Typically surgical procedures are required for cartilage regeneratoon of focal lesions. However, we commonly see improvement of bone edema on MRI post procedure.

bone edema progression

Get on the path to comprehensive healing and long-term pain relief today.

Request an Appointment
Scroll to Top