Although we’re generally unaware of it, our bodies are subject to change – sometimes in reaction to the things that are happening around us.
One example of this is the osteophyte, otherwise known as a “bone spur”. Some years ago, archaeologists working on medieval battle sites realised they were able to identify English archers by their hands: specifically, the little outcrops of bony growth on their wrists and fingers (and sometimes also their shoulders). Something about the repeat movements involved in longbow use had prompted a significant physical change in their bodies.
While excessive longbow use isn’t quite so common in 21st-century Hampshire as it once was, osteophytes are still an issue for some – and the knee is one of the places where we sometimes see them. So what might be causing them, and are they a problem? And, if they are a problem, what should you do about them? Here are some answers.
What is an osteophyte?
Osteophytes are little lumps of bony growth that develop on the surface of other bones and joints in the body. They are created by cells in the periosteum, the delicate tissue that lines our bones and produces new bone growth (for example, to heal a fracture). They can occur in various parts of the body, including the shoulders, back, big toe and neck, as well as the knees. Small amounts of new fibrocartilage may also be produced alongside bone.
Why do they happen?
The cause isn’t always clear. But the most likely reason is to do with degeneration in the existing bone. When the protective cartilage in our joints wears away – which is what happens in osteoarthritis, the most common form of arthritis – the bone endings begin to rub painfully against each other. This prompts a reaction from our bodies. The joint may swell up as it produces more fluid, in an effort to protect itself. Or, in some cases, it may cause the cells in the periosteum to produce more bone and fibrocartilage. Result: an osteophyte.
What problems can they cause?
The good news about bone spurs is that they normally don’t cause major problems in the knees. In fact most patients only tend to realise they have them when they pop up on an x-ray. They are, rather, a marker for an underlying problem in the joint, such as osteoarthritis.
Having said that, prominent osteophytes do have the capacity to cause certain issues in some patients. These include:
Painful rubbing – when the bone spur catches against soft tissues within the joint, causing irritation
Nerve pain – if the osteophyte presses into nerves around the joint, causing pain or numbness
Movement and alignment issues – an example might be when a large osteophyte at the back of the knee puts pressure on the capsule, making it difficult or painful to flex the leg properly
How do we treat osteophytes if you have them?
People sometimes ask us if we can “chip off” the osteophytes in surgery. The answer is that we very rarely do that, largely because it’s not treating the underlying issue. For instance, if osteophytes are occurring in reaction to arthritis in your knee, we would want to investigate the extent of the arthritic damage and create a comprehensive plan to help you manage it. That might include conservative treatments, such as:
Simple painkillers – like paracetamol, to manage the pain or irritation
Anti-inflammatories – like ibuprofen, a non-steroidal anti-inflammatory drug (NSAID)
Physiotherapy – to improve movement and build up strength in muscles surrounding the joint
If there’s significant degeneration and it’s causing you a lot of pain and mobility problems in day-to-day life, we would then discuss the possibility of partial or total knee replacement surgery with you.
It’s worth adding that osteoarthritis isn’t the only factor in osteophyte growth. They can be related to other, rarer conditions, such as diffuse idiopathic skeletal hyperostosis (“DISH”). Again, we would want to properly diagnose and manage these conditions through a tailored treatment plan.
Interested in finding out more? Try these articles
Read more about osteophytes in the NHS’s Health A to Z
Find out more about how your knee works in our Beginner’s Guide to the Knee
Learn more about wear-and-tear arthritis in The 60-Second Guide to Osteoarthritis
If you’re worried about your knees – or experiencing pain, stiffness or other problems in your joints – it’s always a good idea to get them properly looked at. You can book an appointment with Mr Bailey here, or call us direct on 01962 826107. We’ll be really pleased to get you the help you need.