gms | German Medical Science

Joint German Congress of Orthopaedics and Trauma Surgery

02. - 06.10.2006, Berlin

Evidence based dosing of Cryo/Cuff regarding the mid-portion Achilles tendon microcirculation

Meeting Abstract

  • K. Knobloch - Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Germany
  • R. Grasemann - Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Germany
  • M. Richter - Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Germany
  • C. Krettek - Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 92. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 47. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 02.-06.10.2006. Düsseldorf, Köln: German Medical Science; 2006. DocE.7.4-674

The electronic version of this article is the complete one and can be found online at:

Published: September 28, 2006

© 2006 Knobloch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Application of compresssion and cryotherapy are an integral part of the RICE regimen in sports traumatology. However, exact dosing for compression and cryotherapy has not been established on an evidence-based level yet. An initial study over 30min found the main microcirculatory effects within the first ten minutes of application of compression and cryotherapy. Therefore, we studied the combination of compression and cryotherapy (Aircast Cryo/Cuff ankle) on parameters of mid-portion Achilles tendon microcirculation during 3x10min of CryoCuff.

In 26 volunteers (32.3±12yrs, BMI 25.4±5, none on aspirin or with vascular disease) the Cryo/Cuff (AIRCAST, Summit, NJ, USA) was applied with continuous assessment of parameters of Achilles tendon mid-portion microcirculation, such as tissue oxygen saturation (SO2), relative postcapillary venous filling pressures (rHb), and microcirculatory blood flow at 2 and 8mm tissue depths real-time during one hour with a laser-doppler-spectrophotometry-system (O2C, Germany). FAOS score was (90±16/94±17/94±17/91±23/90±19). Superficial SO2 dropped significantly from 35.9±21% to 13.5±15/15.9±16/11.1±11% (p=0.0001) after repetitive CryoCuff application with significant hyperaemia during rewarming (55.4±29/65.2±26/65.7±27%, p=0.003) up to +83% of the baseline level. At 8mm tendon depth, CryoCuff preserved local oxygen with -4% (p=0.001) of the baseline level and small, but significant hyperaemia of up to +13% (p=0.0001). RHb was favourably reduced to 57±34%/67±27%/64±38% (p=0.0004) superficially and deep (76±13%/79±11%/78±18%, p=0.0002). Superficial capillary blood flow was reduced from 48.4±48 to 4.7±6,8/4.4±5/2.7±3,5 (-94%, p=0.0003) with capillary hyperaemia up to 58±64/58±79/47±71 (+20%, p=0.265). Deep flow was reduced from 197±147 to 66.7±64/55±46/43±39 (-78%, p=0.0002) without hyperaemia. CryoCuff administration of 3x10min significantly decreased local Achilles tendon capillary blood flow by -90% with a consecutive small hyperaemia. Postcapillary venous filling pressures are diminished during CryoCuff favouring venous outflow, while superficial oxygen saturation was decreased up to 69%. Deep tendon oxygen supply is not impaired by CryoCuff which is beneficial. Therefore, CryoCuff exerts beneficial effects on the microcirculatory level of the mid-portion Achilles tendon with decreased capillary blood flow, preserved oxygen supply and facilitated venous capillary outflow.