Everything you need to know about the cause, symptoms and treatment options for bone spurs in the knee joint.

What is a Bone Spur?

If you or someone you know has been diagnosed with knee osteoarthritis you’ve likely heard of osteophytes or as they are more commonly known, “bone spurs” and sometimes referred to as “spurring bone”. So, what is a bone spur? Bone spurs are abnormal bony lumps that appear on the surface of joints that have suffered some degree of cartilage loss. Through wear and tear, cartilage, the “cushioning” within the knee joint, slowly degrades resulting in the formation of bone spurs as your body adapts to maintain the stability of the knee joint.

How Are Bone Spurs Diagnosed?

The Kellgren and Lawrence is a scale for progressive stages of knee osteoarthritis.

How & Why Bone Spurs Grow in the Knee

As cartilage degenerates, the bony surfaces of the knee cap (patella), the thigh bone (femur) and shin bone (tibia) begin to place direct pressure on each other. As bone on bone pressure occurs, a cascade of cellular reactions cause the formation of cells called “osteoblasts” which begin building new bone tissue in the areas where the bone has been damaged². This is where osteoarthritis differs dramatically from another common arthritic condition called rheumatoid arthritis.

Bone spurs do not occur in rheumatoid arthritis because the cellular processes involved are purely degenerative, causing virtually no bone growth at all⁴. Without the generation of new bone within the knee joint, it will erode and completely stop functioning⁴. You can think of spurring bone as a rough ‘patch job’ the body performs in response to joint damage and instability.

Risk Factors

PFPS is characterized by pain and inflammation under or surrounding the knee cap (patella) during the stance phase. Similar to ITBS researchers and clinicians have not nailed down the ultimate cause of this issue.⁴ Sex, body weight, age, and joint alignment do not appear to be risk factors for PFPS.⁴ Quadriceps weakness is the only variable that has consistently been associated with the injury.⁴ If this condition is affecting your running, consider taking some time off, trying some cross training, and most of all, getting in the gym to strengthen your thigh muscles.

Impact of Bone Spurs in Knee

Tenderness and pain with a deep knee bend are the primary symptoms of patellar tendonitis. In runners, this condition tends to occur during periods of unusually heavy training. If not rested the condition can become chronic requiring a lengthy rehab process. In general, tendons heal much more slowly than muscle due to poor blood supply, so try not to get frustrated with slow progress.

Recently isometric training has shown to be effective in reducing pain associated with patellar tendonitis. The preliminary research indicates that 5 x 45 second single leg holds on a leg extension machine (video) can provide immediate benefit.⁵

Treatment Options for OA and Bone Spurs in the Knee

Treatment can be divided into two categories: surgical and non-surgical. The former is usually reserved for patients with severe osteoarthritis where conservative treatment has failed to provide relief from symptoms. Surgical removal of osteophytes ranges from minimally invasive arthroscopic techniques to full knee replacements which can require up to 1 year of recovery time.

Arthroscopic Osteophyte Excision

Partial or Total Knee Replacement

Non-Surgical Treatment for Bone Spurs in the Knee

Quadriceps Strength

Slowing the development and reducing the symptoms associated with bone spurs in the knee generally requires decreasing the physical demands on the knee joint itself. According to the International Osteoarthritis Research Society¹⁷ (see full OARSI recommendations here) weight loss can be one of the most effective and practical interventions especially if it is done early in life and sustained over time.

It has been established that both female¹⁸ and male¹⁹ athletes are at a higher risk for knee osteoarthritis and bone spur formation later in life. This may be particularly true for athletes participating in high impact sports that involve repetitive sprinting and jumping.

For those interested in avoiding or delaying surgery so they can maintain a physically active lifestyle or occupation, a compelling case can be made for the use of a knee brace that helps reduce the load on the knee during repetitive or vigorous activity. If you were asking yourself “What is a bone spur and how does it impact my knee health?”, hopefully, this article has improved your understanding. To learn more about how your arthritis may develop and how you and your doctor could manage it read our comprehensive Guide to Severe Knee Arthritis.