The Causal Relationship Between Ankylosing Spondylitis and mechanical complications of prosthesis after arthroplasty: A Two-Sample Mendelian Randomization Study

Background: ： The relationship between ankylosing spondylitis (AS) and mechanical complications of prosthesis after arthroplasty has garnered increasing attention in the medical community. However, the causal relationship between them remains unclear. We conducted a novel study utilizing a two-sample Mendelian randomization analysis to investigate the relationship between these two diseases. Methods: : In this study, we obtained single-nucleotide polymorphisms (SNPs) strongly associated with AS and mechanical complications of prosthesis from summary data from genome-wide association studies (GWAS). AS was used as exposure and SNPs as instrumental variables (IVs). The causality was assessed using inverse variance weighted method, and the results were presented as odds ratios (OR). In addition, we conducted heterogeneity tests, horizontal pleiotropy tests, and sensitivity analysis to investigate the potential existence of any bias that may impact the causal relationship. Results: : Our results indicate that AS has a causal effect that promotes mechanical complications of prosthesis, as assessed by the inverse variance weighted (IVW) method (OR= 1.037, 95% CI = 1.011, 1.062; P = 0.00366). Although the results of other methods such as MR Egger, weighted median, simple mode， and weighted mode showed no significant causal relationship between the two diseases (P > 0.05), the IVW results should be considered the primary criterion of causality, indicating that AS is a facilitator of mechanical complications of prosthesis. Heterogeneity tests, horizontal pleiotropy tests, and sensitivity analysis showed that these results are reliable and stable. Conclusion: In a word, the results of this Mendelian randomized study suggest that ankylosing spondylitis is associated with an increased risk of mechanical complications of prosthesis after arthroplasty. Therefore, it is recommended that AS patients undergo careful assessment and monitoring during the surgical process to minimize the risk of such complications.