Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

37 questions · 40 findings · 5 reviews · Bone, Joint and Muscle Trauma · Headline outcomes only

No studies found 2 · 5%GRADE not reported 2 · 5%Very low 23 · 57.5%Low 9 · 22.5%Moderate 1 · 2.5%High 3 · 7.5%

Surgical vs non‐surgical treatment

Number of participants sustaining recurrent patellar dislocation · people with lateral patellar dislocation

It is very uncertain whether surgical changes number of participants sustaining recurrent patellar dislocationa compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Kujala patellofemoral disorders score Scale from: 0 to 100 (higher scores = better function) · people with lateral patellar dislocation

It is very uncertain whether surgical changes knee and physical functiona Measured using the Kujala patellofemoral… compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Adverse effects of treatment Overall incidence of complications · people with lateral patellar dislocation

It is very uncertain whether surgical changes adverse effects of treatment Overall incidence of complications compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Patient‐reported knee instabilitya Incidence of patellar subluxation · people with lateral patellar dislocation

It is very uncertain whether surgical changes patient‐reported knee instabilitya Incidence of patellar subluxation compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Subsequent requirement for surgery (re‐operations) for complications Incidence · people with lateral patellar dislocation

It is very uncertain whether surgical changes subsequent requirement for surgery (reoperations) for complicationsa… compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Complications requiring unplanned return to theatre Subtalar arthrodesis · people aged over 14 years with displaced intra‐articular calcaneal fractures

Surgical showed no clear difference in complications requiring unplanned return to theatre Subtalar… compared with non‐surgical management (low certainty).

1 finding from 1 review

Early vs delayed mobilisation

Self‐reported shoulder function: Croft Shoulder Disability Score (1 or more problems) · adults with minimally displaced or displaced (2‐part or 3‐part) proximal humeral fractures treated non‐surgically (5 trials)

It is very uncertain whether early changes self‐reported shoulder function: Croft Shoulder Disability Score (1… compared with delayed mobilisation (very low certainty).

2 findings from 1 review

Surgical vs non‐surgical treatment

Functional outcomes · (mainly older) adults with most types of displaced proximal humeral fracturesa (10 trials)

Surgical showed no clear difference in functional scoresf(higher = better outcome) compared with non‐surgical treatment (high certainty).

3 findings from 1 review

Surgical vs non‐surgical treatment

Quality of life: EQ‐5D (0: dead to 1: best quality of life) · (mainly older) adults with most types of displaced proximal humeral fracturesa (10 trials)

Surgical showed no clear difference in quality of life: EQ‐5D (0: dead to 1: best quality of life) compared with non‐surgical treatment (high certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Adverse events / complications ‐ Number of participants with complications · (mainly older) adults with most types of displaced proximal humeral fracturesa (10 trials)

Surgical showed no clear difference in adverse events / complications ‐ Number of participants with… compared with non‐surgical treatment (low certainty).

1 finding from 1 review