Physiotherapy And The Aircast Cryocuff
January 20th, 2010 Posted by: Jonathan Blood Smyth
The Aircast Cryocuff is a useful, portable and flexible device for the management of knee injury, pain and swelling. Used commonly by physiotherapists, it can be an important tool in knee injury and post-operative management of knee operations, where the application of cold therapy is difficult with traditional methods.
Sports and energetic activities cause large numbers of knee injuries which need prompt and appropriate treatments from physiotherapists for the best and speediest outcome. Physios manage a wide variety of knee injuries and conditions including: meniscal (cartilage) injuries, medial ligament injury, lateral ligament injury, anterior cruciate rupture, knee replacement, dislocation of the patella and more general injuries to the knee capsule.
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.
The disadvantages of traditional methods of cryotherapy and compression are several:
* It is difficult or impossible to provide both at once
* Ice application is often not very effective at cooling the knee
* Ice application carries the risk of ice burn by overcooling the skin
* Long periods of cooling are difficult to maintain
* Patients have difficulties keeping the cooling going for any length of time
* Cooling cannot easily be done whilst mobilizing.
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 cooling and compression device which is easy to use and conveniently portable, used in managing acute knee injuries and post-operative knees or other joints. The Cryocuff is made up 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 is the business end of the device. It is a wraparound cuff designed to fit the contours of the knee and comes in three sizes.
Physiotherapy Use of the Cryocuff
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.
Once the bucket has the correct combination of ice and cold water the top is screwed on to prevent leaks. The hose is attached to the cuff by the clipping mechanism and the cuff filled by gravity by lifting the bucket above the level of the cuff. How tight the cuff is can be controlled by the height the bucket is held and for how long.
The cuff is left on for an hour or so until it warms, with the patient able to move about and do exercises. The hose is reconnected and the bucket placed below the knee level to allow the water to flow back into the bucket. Then the bucket is upended a few times to remix the water with the ice and the application procedure repeated. This allows continuous compression and cryotherapy over an extended period, with the ice/water mix remaining cold for six to eight hours before replacement of ice is needed.
