INTER-RATER RELIABILITY OF THE PRONE APPREHENSION RELOCATION TEST (PART)

BACKGROUND: Hip dysplasia and related instability can cause pain, limit hip function, and ultimately result in osteoarthritis. The Prone Apprehension Relocation Test (PART) augments existing radiographic markers and clinical provocative maneuvers in diagnosing hip dysplasia. Reproducibility of the PART between examiners has not been previously studied. HYPOTHESIS/PURPOSE: One measure of the potential clinical utility of the PART depends on the reproducibility of test results by evaluating providers including physicians, licensed athletic trainers, and physical therapists. The purpose of this study is to determine the inter-rater reliability of the PART between health care professionals. METHODS: We retrospectively identified patients in our institution’s hip preservation registry who presented between September 2017 and June 2019 for evaluation of hip pain. Patients included in the study had the PART performed by two health care professionals who were blinded to the other’s results. Inter-rater reliability was assessed using the Cohen 𝜅, with a value of 𝜅 ≥ 0.75 considered excellent inter-rater reliability, between 0.75 and 0.40 moderate, and ≤ 0.40 poor. RESULTS: 96 patients (190 hips) were included, with 63 females and 35 males, average age 32 ± 12.1 years. 23 hips had a positive PART from both examiners. Inter-rater reliability was excellent between health care professionals for the PART when evaluating the right hip (𝜅 = 0.80), left hip (𝜅 = 0.82), and when combining the results for left and right (𝜅 = 0.81). A sub-analysis of patients who had a positive PART from both raters demonstrated that 19 of the 23 hips had a lateral center edge angle > 25°. CONCLUSION: Our study demonstrates that the PART is a reliable physical exam maneuver in the evaluation of hip pain.