Meniscal trimming

Written by Dr Sheila Strover on March 14, 2025

Meniscal trimming is a minor surgical procedure to remove a frayed inner edge of a knee meniscus. It is also referred to as 'arthroscopic partial meniscectomy' (APM).

The controversy about meniscal trimming

When a knee surgeon is investigating symptoms suggestive of a torn meniscus, X-rays and scans may not give a clear answer.

It is generally appropriate to suggest to the patient that the surgeon takes a look inside the joint via arthroscopy. If the menisci look a bit 'tatty' around the edges it is tempting for the surgeon to trim back to healthy meniscal cartilage.

The procedure is known as 'arthroscopic trimming' or 'arthroscopic partial meniscectomy (APM)' and the practice has earned a bad reputation.

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Issues and Controversies

In 2013 the situation with regard to surgical meniscus trimming dramatically changed when a bombshell publication suggested that simply washing out the joint was as effective or more effective than trimming the damage away.

Some other papers suggested, in addition, that trimming in the older patient may indeed speed up the onset of arthritis rather than slow it down.

"....Meniscus surgery has come a long way from the old slogan, “If it is torn, take it out!” to the currently accepted slogan, “Save the meniscus!”"....

Mahmut Nedim Doral et al

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The bombshell 2013 publication

So surgical practice that had been common up to this point suddenly changed, and surgeons chose to wash out the joint rather than trim the damaged meniscus.

"....arthroscopic partial medial meniscectomy provides no significant benefit over sham surgery in patients with a degenerative meniscal tear and no knee osteoarthritis. These results argue against the current practice of performing arthroscopic partial meniscectomy in patients with a degenerative meniscal tear...."

Raine Sihvonen et al

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Trimming a meniscus

Video of the surgical procedure of meniscal trimming, courtesy of Dr Ram Venkatesh

A-Z Keywords - Partial meniscectomy, Degenerate meniscus

Forum discussions - Re: Got a second opinion on my knee...should I seek a third? - Pain issues after partial meniscectomy.

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