Intraosseous PRP — repair where the joint is load-bearing.
PRP placed into the subchondral bone, not only the joint space — for deep, load-bearing problems, image-guided.
What it is
Intraosseous PRP places platelet-rich plasma into the subchondral bone — the load-bearing bone just beneath the cartilage — in addition to the joint space. It uses your own platelets — prepared and measured the same way as every case here. Learn how our PRP differs.
Most joint injections treat the joint space — the cavity between the cartilage surfaces. In a joint that has degenerated over years, that is only part of the picture. The bone directly beneath the cartilage, the subchondral bone, remodels under load as the cartilage above it thins. It is dense, it is richly innervated, and in advanced degeneration it is frequently where part of the pain is actually coming from.
Intraosseous delivery treats that layer as well as the joint space — a compartment a standard injection cannot reach, no matter how accurately it is placed.
What it’s used for here
Considered in select cases of advanced joint degeneration where the bone beneath the cartilage is part of the problem.
In practice this means advanced joint degeneration — most often the knee — where imaging shows changes in the bone beneath the cartilage and not simply cartilage wear alone. It is considered where a standard intra-articular approach has not held, and where the diagnosis points specifically at the subchondral layer.
Precision is the point
Placement is ultrasound-guided to reach the subchondral target accurately.
Reaching subchondral bone is a different technical problem from an intra-articular injection: the target is inside dense bone rather than an open cavity, and it has to be entered at the right depth, at the right point. As with every procedure here, comfort is planned for, with nitrous oxide, oral sedation, and regional or peripheral nerve blocks available.
Chosen carefully
Intraosseous delivery reaches a target most treatments cannot — the load-bearing bone beneath a worn joint, where the pain of advanced degeneration so often lives. Dr. Paul offers it where the diagnosis points there, as part of a comprehensive treatment plan.
Common questions
Asked and answered
How is intraosseous PRP different from a standard PRP injection?
Intraosseous PRP places platelet-rich plasma into the subchondral bone — the load-bearing bone just beneath the cartilage — in addition to the joint space. It uses your own platelets.
Who is intraosseous PRP considered for?
It is considered in select cases of advanced joint degeneration where the bone beneath the cartilage is part of the problem.
How is the placement guided?
Placement is ultrasound-guided to reach the subchondral target accurately.
Does intraosseous PRP work for everyone?
This is an advanced option for specific problems; evidence is still developing and it is not right for everyone. It is applied judiciously, after diagnosis.
Educational information, not medical advice or a diagnosis. Care is individualized; not every treatment is right for every patient, and results vary.