Hyperuricemia is associated with altered perioperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and inflammatory responses in patients residing in high-altitude regions who underwent anterior cruciate ligament reconstruction: A cross-

Objective Hyperuricemia is a common metabolic disorder linked to systemic inflammation; however, its impact on perioperative hematological and inflammatory markers in patients residing in high-altitude regions who have undergone anterior cruciate ligament reconstruction remains unclear. We hypothesized that hyperuricemia is associated with a heightened perioperative inflammatory response. Methods This retrospective, cross-sectional study included 83 long-term high-altitude (≥2500 m) residents who underwent anterior cruciate ligament reconstruction between 2019 and 2025. Patients were divided into hyperuricemia (n = 40) and normouricemia (n = 43) groups based on their serum uric acid levels. Inclusion criteria included isolated anterior cruciate ligament injury, complete perioperative laboratory records, and confirmed preoperative hyperuricemia based on serum uric acid levels. Exclusion criteria included systemic inflammatory disease and incomplete data. Perioperative hematological and inflammatory parameters—including platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio—were compared using t-tests and chi-square tests. Results Preoperatively, the hyperuricemia group had lower neutrophil-to-lymphocyte ratio (1.17 ± 0.92 vs. 1.91 ± 0.82, p  < 0.001) and platelet-to-lymphocyte ratio (101.6 ± 28.4 vs. 116.4 ± 31.9, p  = 0.028) but higher lymphocyte count (2.21 ± 0.56 vs. 1.91 ± 0.47, p  = 0.009) than the normouricemia group. Postoperatively, compared with the normouricemia group, the hyperuricemia group showed elevated white blood cell count (10.82 ± 2.90 vs. 8.23 ± 2.55, p  < 0.001), neutrophil count (7.98 ± 2.88 vs. 5.55 ± 2.23, p  < 0.001), and lymphocyte count (2.63 ± 2.36 vs. 1.75 ± 0.52, p  = 0.023) but lower platelet-to-lymphocyte ratio. Conclusion Hyperuricemia is associated with altered perioperative hematological profiles and amplified inflammatory responses in patients residing in high-altitude regions who have undergone anterior cruciate ligament reconstruction, underscoring the need for targeted perioperative monitoring.