Retrospective evaluation of patch testing before or after metal device implantation

Objective: To review the results of patch testing before or after metal device implantation. Design: Retrospective medical chart review. Setting: Tertiary care academic medical center. Patients: All patients who underwent patch testing before or after metal device implantation. Interventions: Patch testing. Results: From January 1999 through March 2006, 44 patients underwent patch testing in conjunction with metal device implantation, 22 preoperatively and 22 post-operatively. The reason for preoperative patch testing was a history of allergy to metals. Five patients had positive results for a component of the proposed device. The reasons for postoperative patch testing were unexplained skin eruptions at the implantation site (13 patients), chronic joint pain (8 patients), and joint loosening (1 patient). None of the patients had positive patch test results to a component of the previously implanted device. Conclusions: Although the numbers of patients in this study were small, patch testing performed before metal device implantation was helpful in guiding the choice of device selected. Patch testing after implantation was of limited value.