The gut microbiota may be a novel pathogenic mechanism in loosening of orthopedic implants in rats

Abstract

Particles released from implants cause inflammatory bone loss, which is a key factor in aseptic loosening, the most common reason for joint replacement failure. With the anticipated increased incidence of total joint replacement in the next decade, implant failure will continue to burden patients. The gut microbiome is increasingly recognized as an important factor in bone physiology, however, its role in implant loosening is currently unknown. We tested the hypothesis that implant loosening is associated with changes in the gut microbiota in a preclinical model. When the particle challenge caused local joint inflammation, decreased peri-implant bone volume, and decreased implant fixation, the gut microbiota was affected. When the particle challenge did not cause this triad of local effects, the gut microbiota was not affected. Our results suggest that cross-talk between these compartments is a previously unrecognized mechanism of failure following total joint replacement. K E Y W O R D S bone volume, gut microbiome, implant, implant fixation, orthopedics | 14303 MORAN et Al. Vehicle Yes No 12 10 LPS-PE Yes Yes (LPS-doped PE) 12 12 Total 61 Experiment 3 Naïve No No 12 10 Vehicle Yes No 12 10 CoCr Yes Yes (CoCr) 12 11

Enteropathogenic Escherichia coli Mediates CoCrMo Particle-Induced Peri-Implant Osteolysis by Increasing Peripheral 5-HT

“…(2016) suggested that deleting gut flora inhibited bone formation by decreasing serum insulin-like growth factor 1 (IGF-1). On the other side, not only gut microbiota can regulate particle-induced osteolysis, but particle challenge can affect the balance of gut microbiota ( Moran et al., 2020 ). Collectively, we demonstrate that gut microbiota mediate CoP-induced osteolysis, but the effect of CoP challenge in our experiment on the GM remains to be further explored.…”

The Microbial Revolution in the World of Joint Replacement Surgery

“…The gut microbiota influences the inflammatory capacity of the immune system, which is a key mediator of wear particle-induced osteolysis [61][62][63][64][65] . The gut microbiota of rats with wear particleinduced osteolysis had an increased Firmicutes-to-Bacteroidetes ratio and a reduced abundance of SCFA-producing bacteria, both of which are associated with an increased inflammatory profile 61 . The administration of the probiotic Lacticaseibacillus casei, known for its immunomodulatory and anti-inflammatory properties, protected mice from wear particle-induced osteolysis while also reducing inflammatory markers and osteoclast number 62,63 .…”

“…Altering the gut microbiota could affect osseointegration and the risk of aseptic loosening and periprosthetic fracture. The gut microbiota influences the inflammatory capacity of the immune system, which is a key mediator of wear particle-induced osteolysis 61-65 . The gut microbiota of rats with wear particle-induced osteolysis had an increased Firmicutes-to-Bacteroidetes ratio and a reduced abundance of SCFA-producing bacteria, both of which are associated with an increased inflammatory profile 61 .…”