Results of treatment strategies for acute LAS*
| Treatment strategy | Effect | Studies | Patients (N) | (S) MD/RR (95% CI) | In favour of |
| RICE versus control | Swelling (in mL) Swelling (in mm) | 1 RCT 1 RCT | 44 32 | MD −47.00 (–65.07 to 28.93) MD −2.30 (–3.86 to 0.74) | RICE RICE |
| ROM | 1 RCT | 44 | MD 3.00 (–1.35 to 7.35) | None | |
| NSAIDs versus placebo | Pain | 1 RCT 5 RCTs | 60 942 | RR 0.51 (0.38 to 0.68) MD −5.42 (–6.91 to 3.93) | NSAIDs |
| Swelling (in mm) | 3 RCTs | 455 | MD −0.94 (–1.35 to 0.52) | NSAIDs | |
| ROM restriction | 1 RCT | 51 | RR 0.85 (0.50 to 2.40) | None | |
| Complications | 3 RCTs | 641 | RR 1.17 (0.79 to 1.74) | None | |
| Immobilisation versus functional support | Pain | 10 RCTs | 571 | RR 0.68 (0.54 to 0.85) | Immobilisation |
| Swelling | 7 RCTs | 520 | RR 0.68 (0.44 to 1.04) | None | |
| ROM restriction | 3 RCTs | 390 | RR 1.42 (0.91 to 2.21) | None | |
| Satisfaction | 5 RCTs | 347 | RR 1.83 (1.09 to 3.07) | Functional support | |
| PROMs | 3 RCTs | 336 | MD −2.59 (–3.66 to 1.53) | Functional support | |
| No return to work | 3 RCTs | 214 | RR 2.13 (0.90 to 5.05) | Functional support | |
| Days until return to work | 8 RCTs | 837 | MD 7.80 (3.07 to 12.52) | Functional support | |
| No return to sports | 8 RCTs | 654 | RR 1.34 (0.88 to 2.03) | None | |
| Days until return to sports | 3 RCTs | 195 | MD 4.88 (1.50 to 8.25) | Functional support | |
| Manual mobilisation versus control | Pain | 3 RCTs | 120 | MD −1.20 (–1.68 to 0.72) | Mobilisation |
| ROM increase | 5 RCTs | 161 | MD 5.14 (5.01 to 5.26) | Mobilisation | |
| Exercise therapy | Pain | 2 RCTs 4 RCTs | 166 287 | RR 0.92 (0.78 to 1.08) MD −0.05 (–0.21 to 0.11) | None None |
| Objective instability Subjective instability | 4 RCTs 3 RCTs | 251 174 | RR 0.68 (0.49 to 0.95) RR 0.80 (0.64 to 1.00) | Exercise Exercise | |
| Days until return to work | 4 RCTs | 231 | MD 0.76 (–0.33 to 1.85) | None | |
| Days until return to sports | 2 RCTs | 156 | MD −2.61 (–4.05 to 1.16) | Exercise | |
| Surgery versus conservative | Pain | 14 RCTs | 1553 | RR 0.75 (0.56 to 1.00) | Surgery |
| Swelling | 12 RCTs | 1423 | RR 0.88 (0.58 to 1.32) | None | |
| ROM restriction | 7 RCTs | 746 | RR 1.95 (1.16 to 3.28) | Conservative | |
| Complications | 14 RCTs | 1614 | RR 5.01 (2.33 to 10.77) | Conservative | |
| No return to sports | 4 RCTs | 409 | RR 0.68 (0.35 to 1.35) | None |
*For details, analyses and figures, see online supplementary appendix 3.
Control, same therapy without intervention therapy; NSAID, non-steroidal anti-inflammatory drug; RCT, randomised controlled trial; RICE, Rest Ice Compression Elevation; ROM, range of motion; RR, relative risk; (S) MD, (standardised) mean difference; PROM, Patient Reported Outcome Measure.