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This evidence supports the off-label use of botulinum toxin as a novel therapeutic strategy for KOA management in orthopedic practice (107)

Ko SJ, Kang NH, Kim MK, Park J, Park E, Park GH, Kang TW, Park JB, Yi YE, Jeon SH, Park Y (2019) Antibacterial and anti-biofilm activity, and mechanism of action of pleurocidin against drug resistant Staphylococcus aureus

Thus, the nutrient-microbe-host meta-organismal framework linking diet and microbial metabolism to fibrosis represents a targetable pathway for therapeutics, and it will be interesting to see if selectively inhibiting microbial TMA lyase translates to a decreased propensity of fibrosis