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Recently, the American Academy of Orthopaedic Surgeons (AAOS) put together a blue ribbon panel of 16 leading physicians and medical professionals to establish current and future non-surgical guidelines for the treatment of Osteoarthritis of the Knee. These guidelines are based on a systematic review of the current scientific and clinical research in the field with recommendations from the AAOS, the American College of Rheumatology, the American Academy of Family Practice and the American Physical Therapy Association.
This evidence-based guideline contains 15 recommendations to help the practitioner and the patient deal with the ongoing limitations caused by osteoarthritis of the knee. A summary of these guidelines is found in this table.
 One of the more interesting changes in this edition of the clinical practice guidelines is the change in position on the use of viscosupplementation or intra-articular hyaluronic acid (HA) injections (e.g., Synvisc, Hyalgan, and Orthovisc). In the previous edition of these guidelines in 2008, the recommendation for use of these materials was "inconclusive." In the 2013 CPG the recommendation reads - "We cannot recommend using hyaluronic acid for patients with symptomatic osteoarthritis of the knee" (Recommendation #9). This carries a "Strong" rating, based on supporting evidence from three high quality and 11 moderate-quality research studies that met the inclusion criteria.
 Similarly, recommendations for the use of growth factor injections and/or platelet rich plasma for patients with symptomatic osteoarthritis of the knee is - "Inconclusive." Although there remains great interest in this treatment, it is expensive and not covered by most insurance companies. With high cost and equivocal outcomes, this treatment does not have the compelling evidence required by this group as yet.
There are many more recommendations offered by this panel in the non-surgical treatment of osteoarthritis of the knee. A more detailed summary of these findings and recommendations can be found on the Academy of Orthopaedic Surgeons website.
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