Prosthesis is the new Gold Standard for rhizarthrosis surgery in France

Rhizarthrosis is a frequent degenerative condition and a major source of pain and functional impairment. While several surgical options are available, international practice remains heterogeneous, and contemporary nationwide data describing temporal trends in France are limited.

To describe nationwide trends in the surgical management of rhizarthrosis in France over a 16-year period using exhaustive medico-administrative data, and to compare these trends with surgeons' declared practices.

A retrospective nationwide analysis was conducted using the French hospital discharge database from 2009 to 2024. Surgical procedures were identified using codes as proxies for trapeziometacarpal arthroplasty, trapeziectomy, extension osteotomy, and arthrodesis. Annual volumes and incidence rates were calculated. These population-level data were compared with results from two nationwide surveys conducted among members of the French Society for Surgery of the Hand in 2018 and 2025.

The total number of surgical procedures increased from 7,564 in 2009 to 20,406 in 2024, with incidence rising from 11.8 to 29.8 procedures per 100,000 inhabitants. Trapeziometacarpal arthroplasty became the dominant technique, accounting for 75.1% of procedures in 2024. Survey data showed a parallel shift in surgeons' practices, with the proportion reporting a predominance of arthroplasty increasing from 52.5% in 2018 to 85.9% in 2025. Implant activity became increasingly concentrated among high-volume surgeons, and total joint arthroplasty largely replaced interposition implants.

Over the past two decades, surgical practice in France has undergone a profound shift, with trapeziometacarpal arthroplasty progressively supplanting trapeziectomy as the reference surgical strategy for rhizarthrosis. These findings highlight the need for procedure-specific coding and a nationwide registry to ensure long-term surveillance of implant outcomes.

IV (Retrospective epidemiological study).