Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,092 questions · 3,199 findings · 339 reviews · Headline outcomes only

No studies found 714 · 22.3%GRADE not reported 181 · 5.7%Very low 695 · 21.7%Low 908 · 28.4%Moderate 568 · 17.8%High 133 · 4.2%

High‐intensity vs low‐intensity exercise programmes

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · patients with patellofemoral pain syndrome (untreated PFPS of over 2 months in duration)

It is very uncertain whether high‐intensity changes usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) compared with low‐intensity exercise programmes (very low certainty).

2 findings from 1 review

Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · patients with patellofemoral pain syndrome (symptoms > 3 weeks (1 study); symptoms > 1 month (3 studies); symptoms > 2 months (2 studies);…

It is very uncertain whether exercise therapy changes usual pain (long‐term) VAS (0 to 10; higher scores mean worse pain) compared with a control strategy (no treatment, placebo or waiting list controls) (very low certainty).

1 finding from 1 review

High‐intensity vs low‐intensity exercise programmes

Functional ability · patients with patellofemoral pain syndrome (untreated PFPS of over 2 months in duration)

It is very uncertain whether high‐intensity changes functional ability (short‐term) FIQ modified (0 to 16; higher scores… compared with low‐intensity exercise programmes (very low certainty).

2 findings from 1 review

Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls)

Functional ability · patients with patellofemoral pain syndrome (symptoms > 3 weeks (1 study); symptoms > 1 month (3 studies); symptoms > 2 months (2 studies);…

It is very uncertain whether exercise therapy changes functional ability (short‐term) Scale (0 to 100; higher scores mean… compared with a control strategy (no treatment, placebo or waiting list controls) (very low certainty).

2 findings from 1 review

Exercise therapy vs a control strategy (no treatment, placebo or waiting list controls)

Recovered · patients with patellofemoral pain syndrome (symptoms > 3 weeks (1 study); symptoms > 1 month (3 studies); symptoms > 2 months (2 studies);…

It is very uncertain whether exercise therapy changes recovery (long‐term) Number of patients who had recovered or number… compared with a control strategy (no treatment, placebo or waiting list controls) (very low certainty).

1 finding from 1 review

Ultrasound guidance vs anatomical landmarks

Other complications (thrombosis, embolism, haematomediastinum and hydromediastinum, haematothorax and hydrothorax, pneumothorax, subcutaneous emphysema, nerve injury) · patients with femoral vein cannulation for central vein catheterization

Ultrasound guidance showed no clear difference in other complications (thrombosis, embolism, haematomediastinum and… compared with anatomical landmarks (low certainty).

1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Functional outcomes · Children and adolescents with femoral shaft fractures
1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Unacceptable malunion · Children and adolescents with femoral shaft fractures

Surgical interventions probably leads to lower unacceptable malunion Assessed by imaging compared with conservative interventions (moderate certainty).

1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Serious adverse events · Children and adolescents with femoral shaft fractures

Surgical interventions may leads to higher serious adverse events compared with conservative interventions (low certainty).

1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Time to return to usual activities⁶(time to return to school) · Children and adolescents with femoral shaft fractures
1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Child satisfaction Assessed by an ordinal rating scale (11 points): very unhappy to very happy · Children and adolescents with femoral shaft fractures
1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Parent satisfaction Rated as excellent or good · Children and adolescents with femoral shaft fractures

Surgical interventions may leads to higher parent satisfaction Rated as excellent or good compared with conservative interventions (low certainty).

1 finding from 1 review

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Resource use and other costs · Children and adolescents with femoral shaft fractures

The review found no eligible studies for this question.

1 finding from 1 review