Biologic Injections
We are unable to recommend for or against growth factor injections and/or platelet rich plasma for patients with symptomatic osteoarthritis of the knee.

Rationale
There was a paucity of articles on the use of platelet concentrates in the treatment of osteoarthritis. Sanchez et al.119;120 used activated platelet aggregates in a fibrin matrix and Spakova et al.121 used a platelet concentrate.  None of the studies controlled for platelet volume.  All studies used hyaluronic acid as the control group.

The studies showed decreased levels of pain in the post injection period but they were not constructed to allow for a comparative analysis of clinical effectiveness. The lack of controlled prospective blinded randomized clinical trials with a placebo control prevent the work group from making any recommendation on the use of platelets or platelet derived growth factor concentrates in the treatment of osteoarthritis of the knee. 

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