Intrarater and interrater reliability of a manual technique to assess anterior humeral head translation of the glenohumeral joint

The purpose of this study was to determine the intrarater and interrater reliability of a manual anterior humeral head translation test. Fifteen subjects were positioned lying in a supine position with their identity shielded from examiners. A standard manual anterior humeral head translation test was performed and repeated with the glenohumeral joint in 90° of elevation in the scapular plane, with use of the grading method proposed by Altchek and Dines in 1993. Reliability was assessed with the coefficient of agreement and κ statistic. Intrarater reliability was 81.4% comparing grade I and II translation. This decreased to 54% when examiners distinguished between grades I, I+, II, and II+. Interrater reliability for the same comparisons was 70.4%, decreasing to 37.3%.On the basis of these data, the technique of manually assessing anterior humeral head translation studied has poor overall interrater reliability and only fair intrarater reliability. The test-retest accuracy of humeral head translation is enhanced when examiners only determine the relationship of the humeral head relative to the glenoid rim. (J Shoulder Elbow Surg 2002;11:470-75)