Physiotherapy – Use of the Aircast Cryocuff

Knee injuries and the management of post-operative knee conditions require physios to apply cold therapy to the joints to control knee effusions and pain. This is difficult to do with traditional methods but the Aircast Cryocuff is a flexible and efficient device to achieve effective cryotherapy and compression.

Physiotherapists commonly assess and treat knee injuries and post-operative knee conditions, managing them promptly for speedy recovery and return to normal function. Recreational activities and sport involve many knee injuries such as ligamentous injuries to the medial, lateral and anterior cruciate ligaments, meniscal injuries to the knee cartilages, dislocation of the kneecap and injury to the knee capsule and knee joint replacement.

The knee is the largest synovial joint in the body and when the joint is damaged it responds by becoming inflamed, increasing the metabolic rate of the tissues and secreting large amounts of synovial fluid into the joint. This can lead to a knee effusion, a large and tight swelling of the knee, at times called “water on the knee”. An effusion can be painful in itself and it inhibits normal muscle function, thereby interfering with muscle action and joint recovery.

Physiotherapy methods of cooling tissues usually have some disadvantages:

Providing cold and compression at the same time is very difficult/impossible
Applying ice to the knee does not provide effective cooling in many cases
An ice burn can occur with ice by cooling the skin too profoundly
Long periods of cooling are difficult to maintain
Individuals find it hard to keep the cooling going for long periods
Patients cannot be mobile with traditional ice techniques.

Research indicates that compression rather than cooling might be the really important aspect in the management of the acute knee, so this needs to be the priority

The Aircast Cryocuff

The Aircast Cryocuff is a portable, convenient device for providing both compression and cooling for the management of acute or post-operative knee (or other joint) conditions. It consists of three parts:

The Reservoir. This cylindrical bucket is plastic with a lid, is stable, light and holds the water and ice needed for the cuff. Level indicators inside the bucket guide the physio to the correct mixture of cold water and ice. Once full the lid is screwed on the bucket is watertight and can be turned upside down or fall over onto its side without leakage.
The Hose. The hose from the reservoir to the cuff is insulated and allows rapid clipping and unclipping to and from the cuff.
The Cuff. This wraps intimately round the knee to give a good contact and comes in small, medium and large.

Physiotherapy Application of the Cryocuff

The knee size of the patient 15 centimetres above the knee determines the size of the cuff needed and then the physio fits the cuff firmly to the patient’s knee with the Velcro. The cuff needs to be deflated and firmly attached to get the benefits of the compression, otherwise the cuff will inflate on the knee and but not squeeze the tissues.

The bucket should contain the correct mixture of cold water and cubed ice with the top screwed on well to avoid leaks. The physio attaches the hose to the clip on the cuff and lifts the bucket above knee level to allow the cold water to fill the cuff by gravity. The height of the bucket and how long it is held up will determine how tight the cuff is inflated with water.

The patient is able to disconnect the hose from the cuff and remain mobile while the cuff stays cold for an hour or so, providing the cryotherapy and compression required. They can also do their exercises with the cuff in place. Patients can then reconnect the hose, allow the water to flow back into the bucket then remix it by tilting the bucket before repeating the process of refilling the cuff with cold water. The procedure can then be kept up for six to eight hours before fresh ice needs to be provided for the bucket.

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