Translation of the glenohumeral joint in patients with anterior instability: Awake examination versus examination with the patient under anesthesia

Fifty patients with a clinical diagnosis of traumatic anterior shoulder ins tability underwent bilateral shoulder translation testing while both awake and under anesthesia. Each patient was examined by 2 surgeons Following gui delines developed by the American Shoulder and Elbow Surgeons. A single tra nslation grade was established For anterior posterior, and inferior directi ons. A comparison of means was performed with a paired t test. The mean ant erior translation grade was significantly higher on the affected side when compared with that of the unaffected side both during awake examination and during examination with the patient under anesthesia (EUA). Ipsilateral co mparison revealed significantly greater translation for both affected and u naffected shoulders in anterior posterior, and inferior directions during E UA than during awake examination. Side-to-side comparison of posterior and inferior translation was similar for both awake examination and EUA. Clinic al translation testing was helpful in the diagnosis of anterior shoulder in stability Side-to-side differences were subtle while awake and more apparen t during EUA. The usefulness of awake translation testing for traumatic ant erior instability was not clearly demonstrated; however, EUA provides helpf ul information to confirm the direction and degree of instability.