Abstract
* Metal hypersensitivity has been reported in various case reports and cohort studies. Type-IV (delayed-type) hypersensitivity to various implant metals, most frequently nickel, has been implicated in the pathogenesis of metal hypersensitivity.* Currently, there are no guidelines for addressing suspected or known metal allergy preoperatively and there is no evidence-based support for either preoperative testing or routine use of hypoallergenic implants.* Multiple diagnostic modalities are available for the workup of suspected metal hypersensitivity; the 2 most common are patch testing and lymphocyte transformation testing. However, the ability of these tests to diagnose disease and predict outcomes has not yet been demonstrated.* Further research is warranted to help understand the prevalence, pathology, diagnosis, treatment, and potential avoidance of metal hypersensitivity.
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