- resect 30%

- increases contact pressures 3.5 x

- shock absorbing capacity reduced to 20% normal


Results of partial & total meniscectomy are very poor in children

- meniscectomy in children is a last resort

- repair amenable tears

- treat others non-operatively

- only real indication for meniscectomy is locked knee not amenable to repair


Partial better than total

- less OA and less instability

- excision of unstable or loose meniscus with maximum preservation




1.  Partial Meniscectomy

- excision unstable fragments that can be pulled into joint

- stable rim / menisco-capsular junction preserved

- smooth rim, but don't need perfectly smooth as remodels


2. Sub-total Meniscectomy

- excision of portion of rim usually posterior horn


3.  Total Meniscectomy

- required if completely detached and unrepairable


Results Meniscectomy


Total meniscectomy


40% OA at 15 years 

- compared with 6% in normal knee 


Meniscectomy Open


Partial Meniscectomy


1.  No chondral damage at arthroscopy

- 95% good results


Schimmer Arthroscopy 1998

- deterioration over time for partial meniscectomy

- 90% good or excellent at 4 years

- 80% good or excellent at 14 years


2.  Chondral damage at arthroscopy

- if obvious articular damage initially good or excellent 60% at 12 years

- if grade III or IV good or excellent 10%


Technique Excision Bucket Handle Tear



- long standing

- irreparable



1.  98% detachment posterior horn

- scissors / punch

2.  Complete detachment anterior horn 

- can use arthroscopic knife for this portion

- insert through anteromedial portal and cut down

3.  Grasp meniscus firmly with grasper

- roll meniscus several times then twist

- break flimsy posterior attachment

4.  Remove meniscus

- may need to enlarge anteromedial portal

5.  Smooth remaining meniscus with shaver


Lateral Meniscus Bucket HandleMensicus Division Posterior HornPost Removal Bucket Handle Meniscus