Changing patterns in joint replacement surgery in the hand in Sweden: a population-based study of 5382 patients.

Over a 16-year period (2008-2023), data from the Swedish National Patient Register reveal shifting trends in operation for hand joint replacements linked to demographic, healthcare and surgical advances. Among 5382 identified cases, 63% were women, with the incidence peaking in the 65-74 age bracket, highlighting a marked gender gap in middle and older age groups. Regional analyses indicate significant disparities, as Örebro and Halland had rates exceeding 10 per 100,000, while Stockholm and Blekinge fell below 5 per 100,000. The adoption of total prostheses without cement declined by 22%, reflecting changing surgical preferences. Predictive modelling anticipates an overall decline in incidence by 2035, with gender-specific rates converging over time. These findings highlight the need for targeted healthcare policies that address inequities and minimize unwarranted variations in treatment. Standardized care programmes that support evidence-based surgical decision-making could reduce the incidence of both over- and under-treatment.Level of evidence: III.