Percussive vs. Gentle Massage for Recovery After Hip Replacement

Efficacy of Self-Administered Percussive Massage Therapy Versus Gentle Manual Massage to the Thigh Following Anterior Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

Many people who have hip replacement surgery through a "bikini incision" on the front of the hip (anterior approach) develop numbness, tingling, burning, or tightness in the front and side of the thigh afterward. This happens because a small nerve near the incision can get irritated during surgery. For most patients these symptoms fade over time, but for some they can last for months or longer.

This study is testing whether a simple, at-home self-care routine can help these symptoms improve faster. Patients will be randomly assigned to one of two groups: one group will use a handheld percussive massage device (like a massage gun) on the thigh twice a day, and the other group will do gentle hand massage on the same areas, for the same amount of time, twice a day. Both routines take about 5 minutes and are done every day for 6 weeks after surgery. Neither device use nor massage is applied directly on or near the surgical incision.

The researchers want to find out whether the massage device works better than gentle hand massage for improving hip pain and function, reducing numbness and tingling, and improving sleep and comfort during recovery. Participants will complete short questionnaires and daily logs, with follow-up visits at 6 weeks and 3 months after surgery.

Inclusion Criteria:

• Age 18 years or older at the time of surgery
• Scheduled for primary unilateral elective anterior total hip arthroplasty for osteoarthritis, avascular necrosis, or inflammatory arthritis
• Sufficient upper extremity strength and hand dexterity to perform either intervention independently, OR a reliable caregiver willing and able to assist with sessions throughout the 6-week period
• Able to provide written informed consent
• Willing and able to perform twice-daily sessions, maintain a daily log, and attend follow-up visits at Week 6 and Month 3
• Body mass index (BMI) less than 40 kg/m²

Exclusion Criteria:

• Revision arthroplasty or prior ipsilateral hip surgery
• Pre-existing neurological condition affecting the ipsilateral anterior or lateral thigh, including peripheral neuropathy, lumbar L2-L4 radiculopathy, meralgia paresthetica, or diabetic amyotrophy
• Confirmed or history of deep vein thrombosis or pulmonary embolism
• Active wound infection, breakdown, dehiscence, or open incision at any treatment session timepoint
• Coagulopathy, bleeding disorder, or supratherapeutic anticoagulation at time of enrollment
• Active malignancy involving the hip or ipsilateral femur
• Concurrent enrollment in another interventional trial
• Significant cognitive impairment precluding safe self-administration or valid patient-reported outcome completion
• Anticipated contralateral total hip arthroplasty within the 3-month follow-up window