The aging of our population and the availability of new medical technologies have contributed to tremendous growth in the number of patients with implanted orthopedic and other devices. As experts on contact dermatitis, we are periodically asked to evaluate patients who have a history of metal allergy prior to surgery. We are sometimes faced with patients who have experienced complications after implant surgery or (more rarely) who have developed skin disease temporally related to surgery. To address these controversial issues, we asked three experts to discuss the role of patch testing in regard to patients with orthopedic implants. Mark D.P. Davis, MD, is an Associate Professor in the Department of Dermatology, Mayo Clinic, Rochester, MN; Christen M. Mowad, MD, is Assistant Professor of Dermatology, Geisinger Medical Center, Danville, PA; and Pamela Scheinman, MD, is Director of the Contact Dermatitis and Occupational Dermatology Unit and Assistant Professor of Dermatology, Tufts-New England Medical Center, Boston, MA.