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

Hip pain is a common condition that can affect both athletes and the general population. One of the most frequent causes of pain in the front of the hip is a condition known as femoroacetabular impingement (FAI). This occurs when there is an abnormal contact between the bones of the hip joint, which may lead to pain, stiffness, and reduced mobility. In many cases, this pain is also related to surrounding soft tissues, especially the iliopsoas muscle and tendon, which play an important role in hip movement. Although surgery is sometimes used to treat this condition, many patients can benefit from conservative (non-surgical) treatment such as physiotherapy. However, there is still limited evidence on the effectiveness of certain advanced physiotherapy techniques, particularly invasive approaches. This study aims to evaluate the effectiveness of ultrasound-guided percutaneous electrolysis, a minimally invasive physiotherapy technique, when combined with a therapeutic exercise program. This technique involves the application of a small electrical current through a fine needle to targeted soft tissues, with the goal of reducing pain and improving tissue function. Participants in this study will be divided into two groups. One group will receive both percutaneous electrolysis and a structured exercise program, while the other group will perform the exercise program alone. The study will last five weeks, and outcomes such as pain intensity, hip mobility, and hip function will be assessed over time. The main hypothesis of this study is that patients receiving percutaneous electrolysis in addition to exercise will experience greater reductions in hip pain compared to those performing exercise alone. Secondary hypotheses include improvements in hip mobility and hip function, as well as confirmation that the technique is safe, with only minor and temporary side effects. The results of this study may help to improve clinical decision-making and provide evidence for more effective, non-surgical treatment options for patients with anterior hip pain.

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