{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:59:53Z","timestamp":1790312393637,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the longitudinal clinical efficacy of intra-articular polynucleotide (PN) injection combined with prescribed rehabilitation therapy in patients with knee osteoarthritis (KOA) with and without type 2 diabetes mellitus (T2DM), to investigate the influence of glycemic control on treatment outcomes, and to construct a predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 458 patients with KOA who received PN combined with rehabilitation therapy were retrospectively enrolled. After 1:2 propensity score matching (PSM), 270 patients were included (90 in the diabetes mellitus [DM] group and 180 in the non-DM group). Generalized estimating equations (GEE) were used to compare the longitudinal trajectories of Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between the two groups. Stratified analyses were further performed within the DM subgroup according to baseline glycated hemoglobin (HbA1c) levels. Least absolute shrinkage and selection operator (LASSO) regression combined with multivariable Logistic regression was used to construct a nomogram predicting the probability of achieving Patient Acceptable Symptom State (PASS) at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, no significant differences were observed between the two groups in the improvement trajectories of VAS and WOMAC scores (group effect,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Within the DM subgroup, the PASS achievement rate was significantly higher in patients with HbA1c\u2009&amp;lt;\u20097.0% than in those with HbA1c\u2009\u2265\u20097.0% (75.00% vs. 52.38%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0248). The nomogram identified rehabilitation adherence (odds ratio [OR]\u2009=\u20092.95, 95% CI: 1.62\u20135.40), whereas uncontrolled DM (HbA1c\u2009\u2265\u20097.0%; OR\u2009=\u20090.40, 95% CI: 0.22\u20130.78), KL grade IV (OR\u2009=\u20090.35, 95% CI: 0.18\u20130.70), and BMI \u2265 28\u2005kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (OR\u2009=\u20090.58, 95% CI: 0.35\u20130.96) were inversely associated with PASS achievement. The nomogram yielded a C-index of 0.82.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with KOA receiving intra-articular PN injection together with a prescribed rehabilitation program, those with T2DM showed 6-month clinical outcome trajectories comparable to those without DM. Good glycemic control and favorable rehabilitation adherence are key factors for optimizing therapeutic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1906042","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:26:43Z","timestamp":1790310403000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy of intra-articular polynucleotide injection combined with rehabilitation therapy in knee osteoarthritis with and without diabetes mellitus and construction of a nomogram: a propensity score-matched cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Jiangbei Hospital of Traditional Chinese Medicine","place":["Chongqing, China"]},{"name":"School of Orthopedics and Traumatology, Chongqing College of Chinese 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Traumatology, Chongqing College of Chinese Medicine","place":["Chongqing, China"]},{"name":"Orthopedics and Traumatology of Traditional Chinese Medicine Laboratory, Chongqing College of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Li","sequence":"additional","affiliation":[{"name":"School of Orthopedics and Traumatology, Chongqing College of Chinese Medicine","place":["Chongqing, China"]},{"name":"Orthopedics and Traumatology of Traditional Chinese Medicine Laboratory, Chongqing College of Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenming","family":"Bie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Jiangbei Hospital of Traditional Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejie","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chongqing Jiangbei Hospital of Traditional Chinese Medicine","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/S2665-9913(23)00163-7","article-title":"Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"5","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"100614","DOI":"10.1016\/j.ocarto.2025.100614","article-title":"Inflammatory mechanisms underlying metabolic syndrome-associated and potential 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