Overview
Hip pain in the front of the hip is common and can make daily activities and sports difficult. One frequent cause is femoroacetabular impingement, also known as hip impingement.
This clinical trial is studying whether adding ultrasound-guided percutaneous electrolysis - a minimally invasive physiotherapy technique that uses a fine needle and a small electrical current - to a program of specific exercises works better than doing the exercises alone.
Participants will be randomly assigned to one of two groups:
- One group will receive two sessions of percutaneous electrolysis plus a home exercise program.
- The other group will follow the same home exercise program without percutaneous electrolysis.
The study will last five weeks. Researchers will measure pain, hip movement, and hip function at the beginning, after one week, and after four weeks. They will also record any side effects.
The main goal is to find out if adding percutaneous electrolysis helps reduce hip pain and improve function more than exercise alone. This pilot study will help determine if this technique could be a safe and effective non-surgical treatment option for people with pain in the front of the hip.
Description
Femoroacetabular impingement is a common cause of anterior hip pain in young and middle-aged adults. This condition involves abnormal mechanical contact between the proximal femur and the acetabular rim, which can lead to labral damage, cartilage injury, and pain. Soft tissue structures, particularly the iliopsoas tendon and its relationship with the anterior capsulolabral complex, frequently contribute to the symptoms.
Ultrasound-guided percutaneous electrolysis is a minimally invasive technique used in physiotherapy. It involves the application of a controlled galvanic current through a fine needle inserted under ultrasound guidance into targeted soft tissues, with the aim of reducing pain and promoting tissue repair.
This randomized pilot clinical trial will compare the effectiveness and safety of ultrasound-guided percutaneous electrolysis combined with a therapeutic exercise program versus the same therapeutic exercise program alone in participants with anterior hip pain compatible with femoroacetabular impingement.
Eligible participants will be randomly allocated to one of two parallel groups.
Both groups will follow a standardized home-based exercise program focused on hip mobility, gluteal strengthening, core stability, and controlled hip flexor activation. The experimental group will additionally receive two sessions of ultrasound-guided percutaneous electrolysis, performed one week apart.
Primary and secondary outcomes will include pain intensity during provocative tests, hip range of motion to the first onset of pain, and self-reported hip function. All outcome assessments will be conducted by a blinded evaluator at baseline, one week, and four weeks after the first intervention session. Adverse events will be systematically recorded.
The results of this pilot study will provide preliminary evidence regarding the potential additive benefit of percutaneous electrolysis to exercise therapy and will inform the design and sample size calculation of future larger-scale randomized controlled trials
Eligibility
Inclusion Criteria:
- Anterior hip pain (inguinal region) lasting more than 3 months
- Numeric Rating Scale (NRS) pain score ≥ 4/10 during at least one provocative test
- Positive result in at least one of the following clinical tests: Straight Leg Raise (SLR), Flexion-Adduction-Internal Rotation (FADIR), or Hip-External Rotation-Flexion-Ceiling (HEC)
- Ultrasound findings compatible with pseudofibrotic tissue near the iliopsoas tendon at the anterosuperior acetabular recess
- Age between 18 and 55 years
- Able to provide written informed consent
Exclusion Criteria:
- Previous hip surgery
- Moderate or severe hip osteoarthritis (diagnosed radiographically)
- Neurological pathology affecting the lower limb
- Dominant lumbar spine pathology
- Active rheumatic or systemic inflammatory diseases
- Any contraindication to percutaneous electrolysis
- Belonephobia
