The Gut-Joint Axis in Osteoarthritis: A Bibliometric Analysis of Research Trends and Mechanistic Insights (2008-2025).

Abstract

Osteoarthritis (OA) is a leading cause of disability, and emerging evidence highlights the gut-joint axis as critical in its pathogenesis and therapy. To date, no bibliometric synthesis has comprehensively mapped this field. We searched the Web of Science Core Collection (2008-2025) for original studies on gut microbiota and OA. Bibliometric and network analyses were performed using bibliometrix (R) and VOSviewer to assess publication trends, citations, collaborations, and research themes. A total of 175 original articles were identified, with a marked rise in research activity after 2015 and an accelerated growth post-2021. China and the United States are the leading contributors, with China exhibiting the most extensive international collaborations. The University of Calgary and Central South University emerged as top institutions, while journals, such as Osteoarthritis and Cartilage, demonstrated high impact. Thematic analysis revealed seven major research clusters, emphasizing systemic inflammation, metabolic risk factors, molecular mechanisms, and therapeutic strategies targeting the gut-joint axis. Recent years have seen a shift toward translational and mechanistic studies, with increased focus on molecular markers, clinical trials, and precision interventions. The results demonstrate a transition from descriptive and preclinical studies to mechanistic and clinical investigations. Collaborative networks across North America, Europe, and Asia have accelerated progress, but research remains uneven across regions. This bibliometric analysis underscores the rapid expansion of gut microbiota-OA research, highlighting microbial imbalance as a promising therapeutic target. Future work should integrate multi-omics, clinical trials, and global collaboration to advance precision strategies for OA management.