Physiotherapy Use of the Aircast Cryocuff

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.

Physiotherapy methods of cooling tissues usually have some disadvantages:

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 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 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 Use 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.

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 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.