In the July, 2015 issue of the “Journal of Arthroplasty”, authors Alexander McLawhor and M.D. and colleagues from Hospital for Special Surgery in New York reviewed the association of patient-reported multiple drug allergies and outcome following joint replacement. They reviewed patient reported drug allergies in 274 patients undergoing primary total hip and 257 patients undergoing primary total knee replacement. They looked at multiple patient-reported outcomes after surgery and length of stay following surgery. What they found is that patients with increasing numbers of reported allergies to medication had statistically significant lower satisfaction scores, lower patient reported outcomes, and longer lengths of stay after hip and knee replacement. This study is significant in that patient-reported outcomes may have a role in future contracts for joint replacement surgery. It is therefore important to recognize that certain factors may lead to inferior results and that may influence whether or not hospital systems and/or healthcare systems will want to evaluate the significance of the patient with multiple drug allergies. It is important to determine whether or not an allergy to a medication or metal is a true allergic response or more of a minor side effect. All of these factors will need to be evaluated in the future as they will impact the outcome of joint replacement surgery and also potentially affect the selection of implants down the road.