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The Aircast Cryocuff - Use in Physiotherapy

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.

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 a large, synovial hinge joint which is vulnerable to mechanical injury and when injured it reacts with an inflammatory process. This increases the blood supply and metabolic rate of the knee and the synovial lining starts to secrete synovial fluid, a process which forms a knee effusion. This is "water on the knee", a swollen knee with synovial fluid making the knee painful and tight, which can interfere with normal functioning of the knee muscles and cause slow recovery of joint function.

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.

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 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.

Application of the Cryocuff by a Physiotherapist 

The physio will measure the size of the patient's knee six inches above the top of the knee cap to choose the correct cuff size. The cuff is applied to the knee moderately tightly in an unfilled state and the Velcro tightened to make a good fit. It is very important to do this first as without this the compression benefits will not be realised.

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.

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