Evaluation of Electro-Neuro-Feedback (ENF) Treatment in Reducing Post-Surgical Hematoma in Young and Active Patients Undergoing Total Hip Replacement

Background and Objectives: Postoperative hematomas are relatively uncommon complications following total hip replacement (THR) which could result in persistent pain, surgical site infections, neurological deficits, and may require reoperation. The aim of this study is to evaluate the impact of electro-neuro-feedback (ENF), a portable Transcutaneous Electric Nerve Stimulation, in the management of hematomas following THR, focusing on postoperative pain, clinical outcome, and recovery time in a cohort of relatively young and active patients. Materials and Methods: Five 10-minute cycles of ENF Physio of risk class IIa, certificated 0476 were applied. Outcomes included hematoma volume (measured with triaxial ultrasound), thigh circumference, Visual Analog Scale (VAS), Global Perceived Effect (GPE) scale, and HOOS-Physical Function Short (HOOS-PS) form. Results: Twenty participants were enrolled. The reduction in hematoma volume was statistically significant (p-value < 0.001) after five ENF sessions from a pre-treatment mean value of 337.2 mL (SD: 160.5) to 115.9 mL (SD: 78.1) at follow-up. Each patient had a reduction in the hematoma volume superior to 20%. No difference in thigh circumference before and after treatment was reported (p-value = 0.694). Pain according to VAS significantly decreased at follow-up (p < 0.05). Conclusions: The application of ENF was associated with reduced hematoma volume and post-operative pain. These findings can pave the way for future research to evaluate the risks of hematoma following THR.