Summary:Metallic devices have been used successfully by the orthopaedic community for stabilization of fractures and more recently for total joint replacement. The metals used are alloys involving several elements. These alloys were not developed by the medical industry but have been adopted by them because of strength, corrosion resistance, and biocompatibility. In general, the materials are well accepted. However, there is concern because of the recognition that metal is released from the implant into the peri-implant tissue and then is transported to distant sites in the body. Some of the metals are known to be causes of contact dermatitis in the normal human population, and some of them in special forms have been associated with carcinogenicity. Nevertheless, the devices have functioned well without major consequences. It remains important to use the best materials available, to insert them correctly, and to minimize situations that will lead to wear, corrosion, and deposition of particulate debris or ions into the tissue.