Use Of The Aircast Cryocuff By Physiotherapists

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.

Knee injuries are very common in sports and vigorous activities and their acute physiotherapy management is very important for a good outcome and a speedy return to normal activities. Typical knee injuries and conditions managed by physiotherapists include meniscal tears (cartilage tears), medial collateral ligament damage, lateral collateral ligament damage, anterior cruciate ligament tears, patellar dislocation, total knee replacement and capsular injury.

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:

* It is difficult or impossible to provide both at once

* Most ice based methods do not cool the knee effectively

* The skin can however develop an ice burn from overcooling at ice temperatures

* Long periods of cooling are difficult to maintain

* Patients have difficulties keeping the cooling going for any length of time

* Cooling is difficult for an individual to maintain themselves

Physiotherapy treatment priorities have always tended towards cooling the area to reduce the swelling, but prevention of the effusion by early compression may be more important. However, physios do need to provide cooling along with the compression.

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 Bucket. This is a cylindrical plastic reservoir with a detachable lid. It is light and stable and inside there are levels cast in the plastic telling the physio how much ice to put in and where to fill up to with cold water. Once the bucket is prepared the lid is screwed on to give a watertight seal.

* 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.

Application of the Cryocuff by a Physiotherapist

The size of the cuff needed for the patient is measured by the physio 6 inches above the kneecap and then the cuff is fitted snugly to the knee and firmly attached with the Velcro straps. It is important to start with the cuff deflated or the benefits of compression of the Cryocuff will not be forthcoming.

Now the bucket is filled with cubed ice and cold water in the right proportions and the top screwed on firmly to prevent leakage. The hose is clipped to the cuff by pushing the connector into the cuff clip and then the bucket and hose assembly is held up above the knee, allowing the cold water to flow into the cuff by gravity. How high the physiotherapist holds the bucket and for how long has some effect on the tightness of the filled cuff.

The cuff stays cold for an hour or so and the patient can disconnect it from the hose and get on with normal life as able. To change the water the hose is reconnected to the cuff and the bucket put below cuff level to refill the bucket from the cuff, and then the bucket is turned over a few times to remix the water and ice. The process is repeated from the beginning, allowing the compression and cooling to be maintained continuously as the bucket water mixture remains cold enough for 6-8 hours before replenishment.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapist, back pain, orthopaedic conditions, neck pain, injury management and Physiotherapists in Coventry. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.