Orthopaedic practice has traditionally focused on mechanical injury, degeneration, and localized inflammatory processes. Emerging evidence suggests that musculoskeletal health may be significantly influenced by systemic biological networks. Among these, the gut microbiome has gained attention as a key regulator of immune, metabolic, and endocrine pathways influencing bone and joint biology.1,2
The human gut harbors trillions of microorganisms that function as a metabolically active organ. Once considered peripheral to musculoskeletal science, the microbiome is now recognized as a central modulator of systemic inflammation and skeletal homeostasis. This evolving understanding introduces the concept of the gut–musculoskeletal axis, which may reshape our  understanding of many orthopedic pathologies.