Physiotherapy Use of the Aircast Cryocuff
Physiotherapy management of knee injuries and knee operations requires a good way of applying cryotherapy to counter the swelling and pain involved. The Aircast Cryocuff gives physiotherapists this option as traditional ways of applying cold are clumsy and not very effective.
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 a hinge type joint, vulnerable to sporting and other injuries, and it is classified as a synovial joint, lined with synovial membrane. When the knee is injured inflammation occurs, increasing the supply of blood and the metabolism of the surrounding tissues. The synovial membrane secretes amounts of synovial fluid which cause a knee effusion (water on the knee) and this interferes with the muscle control of the knee and can be tight and painful. An effusion can slow recovery if allowed to.
The disadvantages of traditional methods of cryotherapy and compression are several:
Both cold and compression need to be provided and this is hard to achieve Most ice based methods do not cool the knee effectively The skin can however develop an ice burn from overcooling at ice temperatures Compression is difficult to provide along with the cooling 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 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 Water Bucket. This water/ice reservoir is a plastic cylinder with a lid and guidance markings inside the bucket for the proportions of ice and water to fill for optimal use of the device. The lid is screwed on securely to avoid leakage and the contents can be remixed by simply turning the whole assembly upside down a few times. The Hose. The hose has an easy to use clip system to facilitate connection and disconnection of the insulated hose. The Cuff. The material cuff fits snugly around the knee for good anatomical contact, comes in three sizes and Velcro fastenings for a secure fit.
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 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.