Hypersensitivity reactions to orthopedic implants: what's all the hype?

Hypersensitivity reactions to orthopedic implanted materials exist but are rare. Potential allergens include metals and bone cement components. Clinical presentation can include localized or generalized cutaneous reactions and noncutaneous reactions. Preimplant patch testing for implant hypersensitivity reactions (IHRs) is only recommended if metal allergy is strongly suspected; postimplant patch testing to relevant allergens can be completed if symptoms are concerning for implant hypersensitivity. The decision to remove or revise an orthopedic implant should be made as a joint decision between the surgeon and patient.