Metal Allergy Screening Prior to Joint Arthroplasty and Its Influence on Implant Choice: A Delphi Consensus

in joint arthroplasty, particularly in knee joint arthroplasty, can potentially cause surgical delays and additional costs. Although rare cutaneous reactions have been reported follow-ing deep orthopaedic implant usage, the role of metal allergy to ongoing joint pain and early aseptic loosening is still controver-sial7-10). Similarly, there is controversy as to whether cutaneous al-lergy can be indicative of an allergy to deep seated implants4,11,12). There are several recommendations available on managing pa-tients with potential metal allergy undergoing joint arthroplasty. Schalock et al.13) recommended any patient with a prior history of reported cutaneous metal allergy should be patch tested prior to device implantation. Granchi et al.14) also recommended patch testing for any patient with previous signs or symptoms of metal allergy. Patients with positive skin reaction should not have an implant containing the metal allergen if possible14). The aim of our study was to obtain a consensus among joint arthroplasty surgeons who are considered experts in their field within the UK on metal allergy screening prior to joint arthro-plasty surgery and its implication on implant choice