Integrative review of the gut microbiome’s role in pain management for orthopaedic conditions

Table 1 Gut microbiome in orthopedic conditions

Ref.	Orthopedic condition	Key findings on microbiome composition	Main conclusion
Liu et al[50], 2021	Sarcopenia	Decreased lactobacillus and bifidobacterium	Correlation between microbiome and muscle mass
Chakraborty et al[51], 2022	Coronavirus disease	Elevated gut microbes such as Rothia mucilaginosa, Granulicatella spp, Collinsella tanakaei, Collinsella aerofaciens, Morganella morganii, and Streptococcus infantis	Correlation between microbiome and inflammation
Collins et al[52], 2017	Post menopausal osteoporosis	Lactobacillus, Enterococcus, Bacillus, Escherichia, and Bifidobacterium	Improvement in condition by supplementation
Ramires et al[53], 2022	Osteoarthritis	Lower proportion of Bacteroidetes and higher Firmicutes bacterial populations	Correlation between microbiome and bone mass

Table 2 Role of probiotics in orthopaedic conditions

Probiotic strain	Mechanism of action	Orthopedic condition	Outcome	Ref.
Lactobacillus	Autophagy and control of inflammatory cell death of chondrocytes	Osteoarthritis	The daily supply of butyrate showed a tendency to decrease necroptosis by inducing autophagy and reversing impaired autophagy by the inflammatory environment	Cho et al[84], 2022
Lactobacillus	Prevention of growth of Pseudomonas aeruginosa	Orthopedic implant infections	Supplementation with cell-free supernatant demonstrated antiadhesive, antibiofilm, and toxic properties to Pseudomonas aeruginosa	Jeyanathan et al[85], 2021
Bifidobacterium and muribaculum	Reduction in pro-inflammatory cytokines	Fractures	Aging exacerbates the inflammatory response to fracture leading to high levels of pro-inflammatory cytokines and disruption of the intestinal microbiota	Roberts et al[86], 2023
Cumulative	Nociceptive stimulus, neurotransmitters and hormones	Musculoskeletal pain	Modifiable and non-modifiable factors that are known to contribute to changes to the gut microbiome affects musculoskeletal pain	Tonelli Enrico et al[87], 2022