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| Prospective study title | Publication | Author | Results |
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| Sensitivity to implant materials in patients undergoing total hip-replacement | J Biomed Mater Res |
Granchi et al. [19] | Patch test unable to differentiate stable versus unstable implants, equivalent implant lifespan in metal patch +; 10 yr survival for metal patch + 44% versus patch − 47%; poor survival for cement patch + |
| Allergy to components of total hip arthroplasty before and after surgery | Ital J Orthop Traumatol | Cancilleri et al. [20] | 10/66 THA patch + (1/12 w/aseptic loosening patch +), 2/41 preop. patch +; hypersensitivity may play role in loosening, but likely small |
| Metal sensitivity in patients with metal-to-plastic total hip arthroplasties | Acta Orthop Scand | Carlsson et al. [11] | 9/112 patch + preop., 12/112 patch + postop.; all complications except 1/246 explained by reasons other than hypersensitivity |
| Allergy in hip arthroplasty | Contact Dermatitis | Waterman and Schrik [21] | 13/85 patch + preop. (13 metal), 25/85 patch + postop. (23 metal, 2 cement), 0/10 loose THA patch +; no evidence to suggest loosening because of hypersensitivity |
| The development of metal hypersensitivity in patients with metal-to-plastic hip arthroplasties | Contact Dermatitis | Nater et al. [22] | 0/66 patch + preop., 4/66 patch + MOP conversion postop.; no clinical sequelae, no need to test |
| Metal sensitivity in patients with orthopedic implants: a prospective study | Contact Dermatitis | Frigerio et al. [6] | 16/72 (22%) preop. + patch or LTT, (19/72 (29%) postop. (5 conversions of 72 total)); if preop. history insufficient, recommend for screening tests |
| Metal sensitivity before and after total hip arthroplasty | J Bone Joint Surg Am | Deutman et al. [23] | 10/173 patch + preop., 4/66 converted patch + postop. MOP; no conclusion |
| Metal sensitivity in patients undergoing hip-replacement | J Bone Joint Surg Br | Rooker and Wilkinson [10] | 6/69 patch + preop. MOP, only 1/54 patch + postop.; patch + may be effect not cause, no need to screen in MOP |
| The effect of patch testing on surgical practices and outcomes in orthopedic patients with metal implants | Arch Dermatol | Mesinkovska et al. [9] | 31 with history of hypersensitivity preop., 21 patch +, all did well with “allergen-free” implants; 41 suspected of hypersensitivity w/TJA, 10 patch +, 6/10 had resolution of symptoms with allergen free implant; recommend patch testing in those with history |
| Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty | Biomaterials | Niki et al. [24] | 24/92 TKA were mLST+ preop., 5/24 developed eczema, Cr + in eczema patients but not in others; screening indicated |
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| Prospective study summary | | | Preop. patch/LTT +: 56/618 (9.1%), postop.: 73/521 (14.1%)
Conversion of patch/LTT preop. to postop.: 56/618 (9.1%) preop. versus 73/521 (14.0%) postop. |
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