{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:48:15Z","timestamp":1792158495154,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the association between metabolic syndrome (MetSy) and systemic indices of the immune system and inflammation after anterior cruciate ligament reconstruction (ACLR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included adult patients (\u226518\u2009years) who underwent ACLR at a single academic institution between 2009 and 2022. Patients with documented complete blood cell count \u226590\u2009days postoperatively and complete MetSy component data were included. From complete blood cell data, the pan\u2010immune\u2010inflammation value (PIV), systemic inflammation response index (SIRI), systemic immune\u2010inflammatory index (SII), neutrophil\u2010to\u2010lymphocyte ratio (NLR), platelet\u2010to\u2010lymphocyte ratio, and monocyte\u2010to\u2010lymphocyte ratio were calculated. Evidence of MetSy was defined by \u22653 of the following: body mass index \u226530, triglycerides \u2265150\u2009mg\/dL, high\u2010density lipoprotein\u2009&lt;\u200940\u2009mg\/dL (men) or &lt;50\u2009mg\/dL (women), estimated fasting glucose\u2009\u2265\u2009100\u2009mg\/dL, and systolic blood pressure \u2265130\u2009mmHg or diastolic blood pressure \u226585\u2009mmHg. Patients (n\u2009=\u2009130) were grouped based on MetSy status at ACLR: MetSy or non\u2010MetSy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 130 patients were included: 50 MetSy and 80 non\u2010MetSy. The NLR, monocyte\u2010to\u2010lymphocyte ratio, platelet\u2010to\u2010lymphocyte ratio, SIRI, SII, and PIV did not differ significantly between MetSy groups. However, NLR, platelet\u2010to\u2010lymphocyte ratio, SII, and PIV were significantly elevated (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001, and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01, respectively) in women compared with men with MetSy. Patients with higher body mass index and fasting glucose displayed elevated PIV (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03), whereas low high\u2010density lipoprotein was associated with an elevation in NLR, SIRI, SII, and PIV (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04, and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02, respectively). The monocyte\u2010to\u2010lymphocyte ratio, SIRI, SII, and PIV were elevated with postoperative complications (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03, and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Indices of systemic inflammation after ACLR were elevated in women with evidence of MetSy. Patients with postoperative complications also exhibited an elevation in systemic indices of inflammation after ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ars2.70091","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:39:36Z","timestamp":1790095176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Indices of Systemic Inflammation Are Elevated in Women With Evidence of Metabolic Syndrome After Anterior Cruciate Ligament Reconstruction"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9990-0225","authenticated-orcid":false,"given":"Marina","family":"Abdelshahid","sequence":"first","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonu","family":"Bae","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9550-3338","authenticated-orcid":false,"given":"Hayden","family":"Price","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawraa","family":"Al Janabi","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3544-2708","authenticated-orcid":false,"given":"Catherine","family":"Rock","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2022-0868","authenticated-orcid":false,"given":"Anthony","family":"Mantor","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7986-1548","authenticated-orcid":false,"given":"Nicholas","family":"Apseloff","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"Department of Orthopaedic Surgery College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Kaeding","sequence":"additional","affiliation":[{"name":"Sports Medicine Research Institute, College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"Department of Orthopaedic Surgery College of Medicine The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert 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