Ultrasound-guided Needle Percutaneous Electrolysis With Therapeutic Exercise in Femoroacetabular Impingement Syndrome

Effectiveness of Ultrasound-guided Percutaneous Needle Electrolysis Combined With Therapeutic Exercise in Femoroacetabular Impingement Syndrome: a Randomized Pilot Clinical Trial.

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.

Study Overview

• Status: Recruiting
• Conditions: Femoro Acetabular Impingement; Groin Pain; Iliopsoas Syndrome; Hip Pain
• Intervention / Treatment: Other: Ultrasound-guided percutaneous needle electrolysis; Behavioral: Therapeutic exercise program

Detailed 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

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Guillermo Gallardo Lopez; Phone Number: +34656769214; Email: guillermo.gallardolopez@usp.ceu.es

Study Locations

• Spain
  • Madrid
    • Alcobendas, Madrid, Spain, 28109
      • Recruiting
      • Fisioterapia La Moraleja
      • Contact: Guillermo Gallardo Lopez; Phone Number: +34656769214; Email: guillermo.gallardolopez@usp.ceu.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Percutenous electrolysis + therapeutic exercise; Participants receive ultrasound-guided percutaneous electrolysis combined with a therapeutic exercise program	Other: Ultrasound-guided percutaneous needle electrolysis; Ultrasound-guided percutaneous needle electrolysis will be applied to the iliopsoas region targeting hyperechoic fibrotic tissue near the anterior hip joint. The procedure will be performed using a sterile needle under real-time ultrasound guidance with a long-axis in-plane approach from lateral to medial. Electrical current will be delivered with parameters of 2.5 mA for 3 seconds, with a total of 3 applications per session. Two sessions will be performed, one at baseline and one after 7 days. The intervention will be carried out by a physiotherapist with specific training in invasive techniques.; Behavioral: Therapeutic exercise program; Participants will perform a home-based therapeutic exercise program focused on lumbopelvic stability, hip strength, and controlled mobility. Exercises include glute bridge, bird dog, isometric hip flexion, and controlled hip flexion mobility. The program consists of 3 sets of 10 repetitions per exercise, performed 3 to 4 times per week over a 4-week period. Exercises will be performed within pain-free ranges and adjusted according to individual tolerance. Initial instruction will be provided by a physiotherapist, with follow-up supervision at one week and four weeks.
Active Comparator: Therapeutic exercise; Participants receive a therapeutic exercise program without additional invasive intervention	Behavioral: Therapeutic exercise program; Participants will perform a home-based therapeutic exercise program focused on lumbopelvic stability, hip strength, and controlled mobility. Exercises include glute bridge, bird dog, isometric hip flexion, and controlled hip flexion mobility. The program consists of 3 sets of 10 repetitions per exercise, performed 3 to 4 times per week over a 4-week period. Exercises will be performed within pain-free ranges and adjusted according to individual tolerance. Initial instruction will be provided by a physiotherapist, with follow-up supervision at one week and four weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Numeric Rating Scale (NRS) pain score during provocative hip tests	Average pain intensity measured with the Numeric Rating Scale (NRS 0-10, where 0 = no pain and 10 = worst pain imaginable) during three standardized provocative tests: Straight Leg Raise (SLR), Flexion-Adduction-Internal Rotation (FADIR), and Hip-External Rotation-Flexion-Ceiling (HEC). The mean of the three scores is calculated to obtain a global measure of provoked anterior hip pain.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Rating Scale (NRS) pain during SLR test	Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Straight Leg Raise (SLR) test.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Numeric Rating Scale (NRS) pain during FADIR test	Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Flexion-Adduction-Internal Rotation (FADIR) test.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Numeric Rating Scale (NRS) pain during HEC test	Pain intensity measured with the Numeric Rating Scale (NRS 0-10) during the Hip-External Rotation-Flexion-Ceiling (HEC) test.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Hip flexion range of motion to first onset of pain (P1)	Passive hip flexion range of motion measured with a clinical goniometer until the first onset of pain (P1).	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Hip external rotation range of motion to first onset of pain (P1)	Passive hip external rotation range of motion measured with a clinical goniometer until the first onset of pain (P1).	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Hip internal rotation range of motion to first onset of pain (P1)	Passive hip internal rotation range of motion measured with a clinical goniometer until the first onset of pain (P1).	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Adverse events	Incidence and type of adverse events.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)
Hip function and quality of life (Hip Outcome Tool-12, iHOT-12Sv)	Self-reported hip function and quality of life were assessed using the validated Spanish version of the International Hip Outcome Tool-12 (iHOT-12Sv). The iHOT-12 is a patient-reported outcome measure consisting of 12 items, each scored on a visual analog scale ranging from 1 to 100, where higher scores indicate better hip function and fewer symptoms. The overall score is calculated as the mean of the 12 items, resulting in a total score ranging from 0 to 100.	Baseline (T0), 7 days (T1), and 4 weeks after T1 (T2)

Collaborators and Investigators

• Sponsor: CEU San Pablo University
• Investigators: Principal Investigator: Guillermo Gallardo Lopez, CEU SP University

Study record dates

Study Major Dates

• Study Start (Actual): April 22, 2026
• Primary Completion (Estimated): December 26, 2026
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: April 17, 2026
• First Submitted That Met QC Criteria: April 17, 2026
• First Posted (Actual): April 23, 2026

Study Record Updates

• Last Update Posted (Actual): May 5, 2026
• Last Update Submitted That Met QC Criteria: April 29, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Conservative treatment; Range of motion; Therapeutic exercise; Pain intensity; Iliopsoas; Hip function; Percutaneous needle electrolysis; Anterior hip pain; Ultrasound-guided therapy; Ultrasound-Guided Percutaneous Needle Electrolysis
• Additional Relevant MeSH Terms: Neurologic Manifestations; Musculoskeletal Diseases; Pathologic Processes; Joint Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain; Femoracetabular Impingement
• Other Study ID Numbers: CdEi95

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No