The effect of chemotherapy on soft tissue and bone healing in the rabbit model

The effect of chemotherapy on soft tissue and bone healing was studied in a rabbit femoral fracture model. Adriamycin was administered at various intervals preoperatively. Results were compared against a control group in which adriamycin was omitted. Post-chemotherapy blood count profiles were monitored. All animals were operated on with a standard skin incision, osteotomy of the femur and fixation with an intramedullary wire. Soft tissue was assessed with daily clinical scoring and tested for wound breaking strength at two weeks postoperatively. Bone healing was assessed at the time of sacrifice six weeks postoperatively by four-point bending to failure. Clinical scoring of wounds did not show significant differences between control and adriamycin-treated groups. Results of wound breaking strength and four-point bending to failure showed significant impairment for animals given adriamycin four and seven days preoperatively, and no significant impairment when given 14 days preoperatively.

Contrary to previous studies, our results suggest that it is feasible to combine neoadjuvant chemotherapy and early surgery without compromise of soft tissue healing. Our results show that adriamycin impairs bone healing. We postulate that adriamycin has a temporary and reversible inhibitory effect on bone biology. The clinical implications of these findings are discussed.