title: Surface treatment with 5-fluorouracil after flexor tendon repair in a canine in vivo model.
abstract: BACKGROUND
  Topical 5-fluorouracil has been reported to reduce adhesions in animal models of tenolysis. The purpose of this study was to investigate the effects of topical 5-fluorouracil on adhesion formation after tendon repairs were subjected to immediate postoperative rehabilitation in a canine model in vivo.
  
  
  METHODS
  Sixty dogs were randomly assigned to either a 5-fluorouracil treatment (thirty dogs) or a control group (thirty dogs). Each treatment group was then divided into three survival time points: ten days, twenty-one days, and forty-two days. The second and fifth flexor digitorum profundus tendons from each dog were fully lacerated at the zone-II area and then were repaired. Passive motion therapy started at day 5 postoperatively and continued until the dogs were killed. The repaired tendons were evaluated for normalized work of flexion, gliding resistance, repair strength, gene expression for type-I and type-III collagen and transforming growth factor-beta1, and histological appearance.
  
  
  RESULTS
  The normalized work of flexion of the repaired tendons treated with 5-fluorouracil was significantly lower than that of the repaired tendons without 5-fluorouracil treatment at ten days. However, there was no significant difference between treated and untreated tendons at twenty-one and forty-two days. There was also no significant difference in gliding resistance, repair failure strength, or stiffness between treated and untreated tendons at any time point, or in the gross or histological appearance of adhesions at the time of killing. The expression of types-I and III collagen and transforming growth factor-beta1 of the repaired tendon with 5-fluorouracil treatment was significantly lower than that of the tendons without treatment at ten days postoperatively, but not at twenty-one or forty-two days.
  
  
  CONCLUSIONS
  Although 5-fluorouracil treatment can reduce adhesions in in vivo models of tenolysis, this treatment had only a transient effect in an in vivo model of tendon repair that included passive motion.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Zhao
authors.forename: Mark E
authors.initials: ME
authors.lastname: Zobitz
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Sun
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Predmore
authors.forename: Peter C
authors.initials: PC
authors.lastname: Amadio
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
authors.forename: Steven L
authors.initials: SL
authors.lastname: Moran
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000963:Antimetabolites / Q000008:administration & dosage*; D004285:Dogs; D005472:Fluorouracil / Q000008:administration & dosage*; D009140:Musculoskeletal Diseases / Q000517:prevention & control*; D013708:Tendon Injuries / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control
chemical_list: D000963:Antimetabolites; D005472:Fluorouracil