Intraosseous Orthobiologics: A New Frontier in Knee Osteoarthritis Care in Bend, Oregon
Living in Bend, Oregon means an active lifestyle — from hiking Pilot Butte, skiing Mt. Bachelor, or biking along the Deschutes River Trail. But if you’re struggling with knee osteoarthritis (OA), those activities may feel harder every year. Knee arthritis can cause stiffness, swelling, and pain that limits your ability to enjoy Central Oregon’s outdoor life.
At High Desert Sports & Spine (HDSS) in Bend, our team specializes in advanced sports medicine and regenerative therapies. One of the most exciting new options is injections directly into the bone under the joint (called intraosseous, or IO, injections). This therapy uses your body’s own healing cells — known as orthobiologics — such as platelet-rich plasma (PRP) or bone marrow concentrate (BMAC).
Why the Bone Matters in Knee Arthritis
Knee arthritis isn’t just “wear and tear” of cartilage. The subchondral bone (the bone just under the cartilage) also breaks down and can form bone marrow lesions (BMLs). These BMLs show up on MRI scans and are strongly linked to knee pain and faster arthritis progression. At HDSS, we are focused on treatments that target both cartilage and bone — going beyond symptom control to address the root of arthritis pain.
What the Research Shows
Safe and Helpful: Reviews of many studies show that injections into the bone are generally safe and can improve pain and function in knee arthritis patients (Betzler et al., 2021).
Better Than Joint-Only Shots: In animal studies, combining bone injections with joint injections gave better pain relief and slowed cartilage damage compared to joint-only shots, especially when using BMAC (Zhang et al., 2024).
PRP Helps Painful Bone Lesions: A study in patients with advanced arthritis showed that bone injections with PRP reduced pain and improved function for at least a year, and MRI scans even showed bone healing changes (Lychagin et al., 2021).
BMAC May Be Stronger: In studies comparing PRP and BMAC (cells taken from bone marrow), both helped, but BMAC gave better results for pain and activity levels in the first year (Gorbatenko et al., 2022).
Results That Last Years: In patients with severe arthritis, a 4-year study found that BMAC injections led to big improvements in pain, walking ability, and knee function — and most patients avoided knee replacement during that time (Pabinger et al., 2024).
15-Year Study Shows IO Is Better Than Joint-Only: In one of the longest follow-ups ever, a study compared injecting BMAC into the bone vs. into the joint. After 15 years, only 20% of the bone-injected knees needed a knee replacement, compared to 70% of the joint-only knees. Patients overwhelmingly said their bone-injected knee felt better (Hernigou et al., 2021).
What This Means for You
If you have moderate to severe arthritis, especially with MRI evidence of bone marrow lesions, you may be a good candidate for these treatments.
Both PRP and BMAC can help, but BMAC may give stronger and longer-lasting relief.
These injections may not just ease pain — they might also slow or delay the need for knee replacement surgery.
The Bottom Line
For patients in Central Oregon, High Desert Sports & Spine is proud to offer cutting-edge options like intraosseous orthobiologic injections. These treatments target the bone beneath the joint to reduce pain, restore function, and may even delay the need for knee replacement surgery.
If you live in Central Oregon and are ready to explore advanced knee arthritis care, schedule a consultation with the team at High Desert Sports & Spine in Bend to see if bone injections (PRP or BMAC) are right for you.
