The Microbial Revolution in the World of Joint Replacement Surgery

Background:The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies t...

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Published in:JB & JS open access Vol. 9; no. 2
Main Authors: Srikrishnaraj, Arjuna, Lanting, Brent A., Burton, Jeremy P., Teeter, Matthew G.
Format: Journal Article
Language:English
Published: United States Journal of Bone and Joint Surgery, Inc 18.04.2024
Wolters Kluwer
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Scientific
ISSN:2472-7245, 2472-7245
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Abstract Background:The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies that modulate the gut microbiota to influence bone health and systemic inflammation are a novel area of research.Methods:A literature review of preclinical and clinical peer-reviewed articles relating to the role of the gut microbiota in bone health and PJI was performed.Results:There is evidence that the gut microbiota plays a role in maintaining bone mineral density, which can contribute to osseointegration, osteolysis, aseptic loosening, and periprosthetic fractures. Similarly, the gut microbiota influences gut permeability and the potential for bacterial translocation to the bloodstream, increasing susceptibility to PJI.Conclusions:Emerging evidence supports the role of the gut microbiota in the development of complications such as aseptic loosening and PJI after total hip or knee arthroplasty. There is a potential for microbial therapies such as probiotics or fecal microbial transplantation to moderate the risk of developing these complications. However, further investigation is required.Clinical Relevance:Modulation of the gut microbiota may influence patient outcomes following total joint arthroplasty.
AbstractList Background:The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies that modulate the gut microbiota to influence bone health and systemic inflammation are a novel area of research.Methods:A literature review of preclinical and clinical peer-reviewed articles relating to the role of the gut microbiota in bone health and PJI was performed.Results:There is evidence that the gut microbiota plays a role in maintaining bone mineral density, which can contribute to osseointegration, osteolysis, aseptic loosening, and periprosthetic fractures. Similarly, the gut microbiota influences gut permeability and the potential for bacterial translocation to the bloodstream, increasing susceptibility to PJI.Conclusions:Emerging evidence supports the role of the gut microbiota in the development of complications such as aseptic loosening and PJI after total hip or knee arthroplasty. There is a potential for microbial therapies such as probiotics or fecal microbial transplantation to moderate the risk of developing these complications. However, further investigation is required.Clinical Relevance:Modulation of the gut microbiota may influence patient outcomes following total joint arthroplasty.
The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies that modulate the gut microbiota to influence bone health and systemic inflammation are a novel area of research. A literature review of preclinical and clinical peer-reviewed articles relating to the role of the gut microbiota in bone health and PJI was performed. There is evidence that the gut microbiota plays a role in maintaining bone mineral density, which can contribute to osseointegration, osteolysis, aseptic loosening, and periprosthetic fractures. Similarly, the gut microbiota influences gut permeability and the potential for bacterial translocation to the bloodstream, increasing susceptibility to PJI. Emerging evidence supports the role of the gut microbiota in the development of complications such as aseptic loosening and PJI after total hip or knee arthroplasty. There is a potential for microbial therapies such as probiotics or fecal microbial transplantation to moderate the risk of developing these complications. However, further investigation is required. Modulation of the gut microbiota may influence patient outcomes following total joint arthroplasty.
The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies that modulate the gut microbiota to influence bone health and systemic inflammation are a novel area of research.BackgroundThe prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing. Strategies to prevent the need for revision surgery and its associated health-care costs and patient morbidity are needed. Therapies that modulate the gut microbiota to influence bone health and systemic inflammation are a novel area of research.A literature review of preclinical and clinical peer-reviewed articles relating to the role of the gut microbiota in bone health and PJI was performed.MethodsA literature review of preclinical and clinical peer-reviewed articles relating to the role of the gut microbiota in bone health and PJI was performed.There is evidence that the gut microbiota plays a role in maintaining bone mineral density, which can contribute to osseointegration, osteolysis, aseptic loosening, and periprosthetic fractures. Similarly, the gut microbiota influences gut permeability and the potential for bacterial translocation to the bloodstream, increasing susceptibility to PJI.ResultsThere is evidence that the gut microbiota plays a role in maintaining bone mineral density, which can contribute to osseointegration, osteolysis, aseptic loosening, and periprosthetic fractures. Similarly, the gut microbiota influences gut permeability and the potential for bacterial translocation to the bloodstream, increasing susceptibility to PJI.Emerging evidence supports the role of the gut microbiota in the development of complications such as aseptic loosening and PJI after total hip or knee arthroplasty. There is a potential for microbial therapies such as probiotics or fecal microbial transplantation to moderate the risk of developing these complications. However, further investigation is required.ConclusionsEmerging evidence supports the role of the gut microbiota in the development of complications such as aseptic loosening and PJI after total hip or knee arthroplasty. There is a potential for microbial therapies such as probiotics or fecal microbial transplantation to moderate the risk of developing these complications. However, further investigation is required.Modulation of the gut microbiota may influence patient outcomes following total joint arthroplasty.Clinical RelevanceModulation of the gut microbiota may influence patient outcomes following total joint arthroplasty.
ArticleNumber e23.00153
Author Srikrishnaraj, Arjuna
Lanting, Brent A.
Teeter, Matthew G.
Burton, Jeremy P.
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  orcidid: 0000-0002-7828-2779
  surname: Srikrishnaraj
  fullname: Srikrishnaraj, Arjuna
  email: asrikrishnaraj2026@meds.uwo.ca
  organization: Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
– sequence: 2
  givenname: Brent A.
  surname: Lanting
  fullname: Lanting, Brent A.
  email: brent.lanting@lhsc.on.ca
  organization: Bone and Joint Institute, Western University, London, Ontario, Canada
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  givenname: Jeremy P.
  orcidid: 0000-0002-3591-6436
  surname: Burton
  fullname: Burton, Jeremy P.
  email: jeremy.burton@lawsonresearch.com
  organization: Bone and Joint Institute, Western University, London, Ontario, Canada
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  givenname: Matthew G.
  orcidid: 0000-0002-3911-3171
  surname: Teeter
  fullname: Teeter, Matthew G.
  email: matthew.teeter@lhsc.on.ca
  organization: Bone and Joint Institute, Western University, London, Ontario, Canada
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Notes aEmail for corresponding author: matthew.teeter@lhsc.on.caInvestigation performed at the London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, CanadaDisclosure: Funding for this study was provided by an Arthritis Society of Canada Stars Career Development Award and the Schulich School of Medicine & Dentistry Summer Research Training Program. The Article Processing Charge for open access publication was funded by the Arthritis Society. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A623).
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Snippet Background:The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is...
The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is growing....
Background:. The prevalence of revision surgery due to aseptic loosening and periprosthetic joint infection (PJI) following total hip and knee arthroplasty is...
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Title The Microbial Revolution in the World of Joint Replacement Surgery
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