During the Mital/Hyden test, which maneuver is performed on the patella?

• A. Push patella laterally when the knee is extended
• B. Push patella medially when the knee is flexed to 90 degrees
• C. Push patella medially when the leg is flexed to 60 degrees
• D. Push patella medial when the leg is flexed to 30 degrees

Answer: (D)

This tests patellar mobility and tracking by assessing the medial glide of the patella in a midrange of knee flexion. Pushing the patella medially with the knee flexed to about 30 degrees targets a position where the patella is partially engaged in the trochlear groove but still mobile enough to reveal how well the medial stabilizers counterbalance the lateral restraints. If there is excess medial movement at this angle, it suggests patellar laxity or lateral retinacular tightness contributing to maltracking and anterior knee pain. At deeper flexion or near full extension, the patella is either more tightly wedged in the groove or less engaged, making medial glide less informative and reducing the test’s ability to detect instability. Hence, performing the maneuver at about 30 degrees of flexion provides the most diagnostic value for medial patellar mobility.