A tissue cutting instrument includes an outer member, an inner member received within the outer member, and a cutter coupled to the inner and the outer members such that rotation of the inner member about an axis causes off-axis movement of the cutter. A method of cutting tissue includes positioning an outer member such that the outer member is adjacent tissue, engaging the tissue with a cutter coupled to the outer member, and moving the cutter to end-on cut the tissue. The extended portion of the cutter extends distally beyond a terminal end of the outer member.