Bone Spurs in the Hip and Knee: What They Really Mean
A bone spur means there has been too much pressure on that part of the joint. Bone reacts to pressure by forming new bone, so a spur is a sign of arthritis on the X-ray, not the painful issue itself. Here’s where spurs form in the hip, what they say about impingement and dysplasia, why I don’t typically remove them, and what actually decides treatment.
Key takeaways
- A bone spur forms where there’s too much pressure. Bone reacts to pressure by making new bone (Wolff’s law).
- Spurs are a sign of arthritis: the bones are rubbing together and shifting.
- The same pressure tears the soft tissues too: the labrum in the hip, the meniscus in the knee.
- In the hip, spurs form on the top and bottom edges of the socket, often where part of the neck or ball presses (impingement) or a shallow socket overloads one area (dysplasia).
- Spurs aren’t the painful issue themselves. Taking them out doesn’t fix the arthritis, and they would form again.
- Spurs don’t decide surgery. The arthritis behind them, and how much it affects your quality of life and daily activities, does.
When patients hear they have “bone spurs,” they usually think the spurs are the problem. Most of the time they aren't. A spur means there has been too much pressure on that area of the joint, and it's usually a sign of arthritis on the X-ray.
Why do bone spurs form?
Whenever a bone is under pressure, it reacts by forming new bone. This is called Wolff's law. A bone spur, or osteophyte, is that new bone.
With arthritis we commonly see spurs. They mean the bones are rubbing together and shifting, and there's increased pressure on that area. So the spur is really a clue: something is going on here.
Pressure does more than make spurs
Bone spurs in the hip
In the hip, we tend to see spurs on the top and bottom edges of the socket (the acetabulum), and around the ball and neck of the thighbone. Where they form tells us where the pressure has been. Two common reasons:
- Hip impingement: part of the neck or ball presses on the rim of the socket every time the hip bends
- Hip dysplasia: a shallow socket puts too much pressure on a small area of the joint
Either way, the bone spurs form because there's too much pressure. Over time, that pressure wears the cartilage and leads to hip arthritis. For more, see hip impingement (FAI) and hip dysplasia in adults.
What bone spurs on a hip X-ray mean
On an X-ray, spurs rarely show up alone. With arthritis we usually also see the space between the ball and socket narrowing, hardening of the bone underneath, and sometimes small cysts. Together, those tell us the hip has been under too much pressure for a long time. Larger spurs usually go with more advanced arthritis.
That's why I read the whole X-ray, not just the word “spur” on the report.
Bone spurs in the knee
In the knee, we tend to see spurs on the sides of the joint and behind the kneecap, from micro-instability or too much pressure on the bones. The full guide is bone spurs in the knee.
Are the bone spurs causing my pain?
Usually not. The pain comes from the arthritis: the cartilage wearing away, the bones rubbing together and the inflammation in the joint. The spur is what shows up on the X-ray, so it gets the blame.
Should bone spurs be removed?
When spurs come from arthritis, we don't typically remove them. Taking out the spurs leaves the arthritis behind. The bones keep rubbing together, and the spurs form again.
A younger hip with impingement and no arthritis yet is a different conversation. That's covered in hip impingement.
A different kind of bone growth
Some genetic conditions, like multiple hereditary exostoses, cause bone growths that can be really painful. Those are a different problem from the spurs we see with arthritis, and they're treated differently.
Do bone spurs mean I need surgery?
Spurs don't factor into the decision. But when you have a spur, it usually means there's arthritis, and the arthritis does factor in, combined with how it's affecting your quality of life and daily activities. If those are significantly affected, then we look at fixing things.
Most people start with non-surgical treatment: physical therapy, medication and injections. For when it's time to think about surgery, see the signs you may need a hip replacement and the signs for the knee.
What happens to bone spurs during joint replacement?
During a hip or knee replacement, the spurs are removed as a routine step. That's not the point of the surgery, though. The point is to replace the worn surfaces and restore the joint's alignment, which takes away the extra pressure that made the spurs in the first place.
Frequently asked questions
What is a bone spur in the hip?
A bone spur, also called an osteophyte, is new bone the hip forms where there has been too much pressure. Bone reacts to pressure by making more bone. With arthritis we commonly see spurs, so they’re more of a sign of the arthritis on the X-ray than a problem of their own.
What causes bone spurs in the hip?
Too much pressure on one area of the hip. Often part of the neck or ball presses on the rim of the socket, as in hip impingement, or a shallow socket puts too much pressure on a small area, as in hip dysplasia. Over time that pressure leads to arthritis, and the spurs form.
Where do bone spurs form in the hip?
We tend to see them on the top and bottom edges of the socket (the acetabulum), and around the ball and neck of the thighbone (the femoral head and neck). Where they form tells us where the pressure has been.
My hip X-ray says bone spurs. Is that bad?
It usually means there is also arthritis, which is too much pressure on that area. The spur itself isn’t the problem. What matters is the arthritis behind it and how much it’s affecting your quality of life and daily activities.
Are bone spurs causing my hip pain?
Usually not directly. Spurs aren’t the painful issue themselves. The pain comes from the arthritis: the cartilage wearing away and the bones rubbing together. The same pressure that forms spurs can also tear the labrum.
Can bone spurs in the hip be removed?
When they come from arthritis, I don’t typically remove them. If we just took out the spurs, the bones would keep rubbing together and the spurs would form again. They are removed as a routine part of a hip replacement, because the replacement treats the arthritis.
Do bone spurs go away on their own?
No. Spurs don’t shrink or dissolve, and no supplement or injection removes them. But having spurs doesn’t mean you need surgery. Treatment is guided by the arthritis and how much it’s limiting you.
References
This article is for general education and is not a substitute for personalized medical advice. Recovery timelines vary by patient, procedure, medical history, and surgeon-specific protocol. Please consult Matthew Harb, M.D. about your specific condition.
What patients say
“A really smooth operation — I was discharged the same day and basically able to walk easily within a day.”
“I walked into the surgical center in great pain and walked out with a new knee and a renewed person.”
“My full knee replacement is a big success — six months after surgery I’m hiking and kayaking again.”
Keep learning
Signs You May Need a Hip Replacement
Most people with hip arthritis don’t need surgery any time soon — and surgery is rarely the first step. But it helps to recognize when arthritis is genuinely limiting your life, because with a hip replacement, you largely decide when it’s time. The decision is driven by your pain, function, and quality of life — not by an X-ray.
Read articleArthritis & Joint PainBone Spurs in the Knee: What They Are and What They Actually Mean
When we see bone spurs on a knee X-ray, it means there has been too much pressure on that area. Bone reacts to pressure by forming new bone. So a spur is really a sign of arthritis, not the painful issue itself. Here’s what spurs tell me, where they show up in the knee, why I don’t typically remove them, and what actually decides treatment.
Read articleKnee ReplacementSigns You May Need a Knee Replacement
Most people with knee arthritis don’t need surgery any time soon — and surgery is rarely the first step. But it helps to recognize when arthritis is genuinely limiting your life, because with a knee replacement, you largely decide when it’s time. The decision is driven by your pain, function, and quality of life — not by an X-ray.
Read articleHave questions about your hip or knee?
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