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).
Page updated January 2024 by Dr Sheila Strover (Clinical Editor)
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, and 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 is known as 'arthroscopic trimming' or 'arthroscopic partial meniscectomy (APM)' and the practice has earned a bad reputation.
There are several issues:
- the remuneration for a purely diagnostic arthroscopy and that for arthroscopic partial meniscectomy are very different
- there is pressure from the patient to 'do something' and not to simply note the problem
- a bombshell publication in 2013 literature suggests that simply washing out the joint is as effective or more effective than trimming the damage away, and some papers suggest that trimming in the older patient may indeed speed up the onset of arthritis rather than slow it down.
[Citation: Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear]
Trimming a meniscus
Video of a meniscal trim, courtesy of Dr Ram Venkatesh
Quick links
Forum discussions
- Re: Got a second opinion on my knee...should I seek a third?
Pain issues after partial meniscectomy.
Peer-reviewed papers
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Quote:
"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!”"
Citation: Doral MN, Bilge O, Huri G, Turhan E, Verdonk R. Modern treatment of meniscal tears. EFORT Open Rev. 2018 May 21;3(5):260-268. doi: 10.1302/2058-5241.3.170067. PMID: 29951265; PMCID: PMC5994634.