Hip problems symptoms


Our group members have reported some of the following symptoms:


  • Groin or hip pain
  • Clunking, clicking, grinding and other uncommon noises from the joint
  • Walking and mobility problems
  • Numbness
  • Pins and needles


Many people in the group have also reported having no symptoms whatsoever. However, hospital tests have subsequently revealed problems for these people, especially with metal levels in the blood.

We therefore strongly recommend that, if you have been fitted with an ASR hip, you visit your GP or speak to your surgeon to ask for further investigations.

Raised levels of metal ions in blood

When you first find out you have an ASR, it is imperative that your blood is tested for cobalt and chromium levels; and at least every 6 months thereafter.

Two units of measurement are commonly used:

  • Nanomoles per litre (nmol/l)
  • Micrograms per litre(ug/l) - sometimes referred to as parts per billion (ppb)


It is important that you know your blood metal levels and which unit of measurement is used. To find out how to convert units, see our FAQs page.

The Medical Health Regulatory Authority guidelines for the maximum acceptable levels are:

  • cobalt – 7ppb (7 ug/l) and 119 nmol/l
  • chromium – 7ppb (7 ug/l) and 134nmol/l


These are the maximum acceptable levels but some authorities consider action should be taken earlier - particularly if other symptoms are present. If your measurements are above these levels, this indicates there is likely to be a problem and you should seek further treatment. This will typically be scans and x-rays.

Adverse Reaction to Metallic Debris (ARMD)

ARMD is an umbrella term which covers:

  • ALVAL (Aseptic Lymphocyte Dominated Vasculitis Associated Lesion) – this occurs in some patients when white blood cells react to the metal debris, causing a reaction thought to be related to Lymphocytes.
  • Metallosis- an adverse reaction to the metal particles.
  • Pseudo-Tumour - refers to the same condition as ALVAL, usually with the presence of a soft tissue mass. However, it is not a malignancy and should not be confused with cancer.


Any of the above terms may be mentioned in a consultation but If you are not sure about any of these things then you should ask your surgeon for more information.

The dangerous reality of ARMD is better illustrated by the following photos taken during surgery. In some cases the fluid formed can destroy the bone and muscle tissue, making revision surgery even more difficult and the final outcome more uncertain.

(Photos to be inserted of surgical photo of ARMD – to follow. )

Unfortunately, everyone is different and it isn't possible to say or know how well you will recover after revision surgery. Even within the support group there are vast differences with recovery rates. Again, if you have any concerns about this you need to speak to your surgeon.

Long-term consequences.

Naturally this is what everyone wants to know about (us too!) and unfortunately, there is no answer to what the future will hold or the consequences of having all these metal particles in the body. What we do know is that after the metal hip product is removed, the metal ions are excreted through the kidneys and urine so they should start to go down over 9-12 months but obviously the surgeons are still monitoring this.

Investigations are still ongoing into the long term effect of the ASR hips and we will update our news page as soon as we find out more information or the results are published so watch this space!!!



All the information provided by this website and online support group is intended for your general knowledge only and is not a substitute for medical advice or treatment on hip surgery or any other medical conditions. The information should not be considered complete and should not be used in place of a visit, call, consultation or the advice of your doctors.


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07974 545 709
People have joined us from all over the UK and we try to keep in touch with everyone, mainly through the internet, to let members know about topics of interest - such as media coverage and research.

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How do I know if I have been fitted with an ASR?

What should I do if I have been fitted with an ASR?

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