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Does Implanted Ankle Hardware Harbor Bacteria? Identification of the Microbial Profile Using Next-Generation DNA
Luke LaRochelle1, Joshua L Morningstar2, Caroline Hoch3
1Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
Foot & Ankle International
|May 14, 2026
Summary
Next-generation DNA sequencing found no consistent microbiome on foot and ankle hardware removed for non-infectious reasons. Staphylococcus species were most common, but bacterial DNA was detected in only 14.7% of cases.
Area of Science:
- Orthopaedic Surgery
- Microbiome Research
- Molecular Diagnostics
Background:
- Next-generation DNA sequencing (NGS) advances bacterial detection and microbiome understanding in orthopaedics.
- NGS has linked microbes to shoulder surgery outcomes, but its role in foot and ankle hardware removal is unknown.
Purpose of the Study:
- To investigate the microbiome profile of hardware removed from the foot and ankle using NGS.
- To determine if patients undergoing hardware removal surgery have a unique microbiome.
Main Methods:
- Prospective study of 34 patients undergoing elective foot/ankle hardware removal (2020-2023).
- Hardware specimens collected intraoperatively and analyzed via NGS at a CLIA-licensed laboratory.
- Exclusion criteria included any pre-operative concern for infection.
Main Results:
- Bacterial DNA was detected in 5 cases (14.7%), identifying 9 organisms.
- Staphylococcus species (44.4%) and Corynebacterium (22.2%) were the most prevalent bacteria.
- No significant associations found between bacterial detection and patient demographics or reason for removal.
Conclusions:
- Foot and ankle hardware does not appear to consistently harbor detectable bacteria via NGS.
- Staphylococcus species were the most frequently identified organisms in positive cases.
- A small sample size necessitates further research to confirm these preliminary findings.
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