Ethnic impact on knee osteoarthritis pain predictors in an urban Malaysian population: a retrospective study

Knee osteoarthritis (KOA) is a degenerative joint disease associated with chronic pain and disability. Its epidemiology in Malaysia's diverse urban population remains unclear, as previous studies often relied on self-reports, non-standardized diagnostic criteria, and predominantly rural samples. This study assesses the prevalence of symptomatic KOA and its sociodemographic and pain-related predictors in an urban Malaysian cohort.

This retrospective cross-sectional study drew data from newly diagnosed cases of symptomatic KOA at University Malaya Medical Centre, based on the American College of Rheumatology criteria, between 2017 and 2020. A random, ethnicity-stratified sample of 600 medical records was analysed using descriptive and logistic regression statistics.

Of 17,253 new cases, 20.5% (n = 3,529) were diagnosed with symptomatic KOA; (i) 43.4% were Chinese, 28.9% Malay, 27.6% Indian, and 2.1% from other ethnic groups. Most patients were aged ≥65 (60.2%), female (72.1%), and overweight/obese (71.1%). Significant associations were observed between symptomatic KOA prevalence and (i) alcohol consumption among Chinese (62.9%) and (ii) low financial status, smoking, and physical inactivity among Indians (33.3%). Modifiable predictors of poor pain outcomes included sedentary lifestyles and non-adherence to rehabilitation, while severe disease stage and lower education were non-modifiable predictors.

Ethnic disparities in KOA prevalence and risk factors in urban Malaysians highlight the importance for tailored interventions to improve rehabilitation adherence, promote physical activity, and address lifestyle risks such as alcohol and smoking. These findings emphasize the need for culturally sensitive healthcare strategies to ensure effective KOA management in this diverse population.