{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:50:00Z","timestamp":1792522200379,"version":"4.5.0"},"reference-count":97,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else-Kr\u00f6ner-Fresenius Stiftung","doi-asserted-by":"publisher","award":["2021_EKEA.129"],"award-info":[{"award-number":["2021_EKEA.129"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Open Access Publishing Fund of the University of Muenster","award":["2021_EKEA.129"],"award-info":[{"award-number":["2021_EKEA.129"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Polymers"],"abstract":"<jats:p>Poly-L-lactic acid (PLLA) implants have been used for bone fixation for decades. However, upon insertion, they can cause a foreign body reaction (FBR) that may lead to complications. On 15 December 2023, a systematic review was conducted to search for articles on the PubMed, MeSH term, and Scopus databases using the keywords \u2018PLLA\u2019 and \u2018foreign body reaction\u2019. The articles were reviewed not only for the question of FBR, its severity, and the manifestation of symptoms but also for the type of implant and its location in the body, the species, and the number of individuals included. A total of 71 original articles were identified. Of these, two-thirds reported on in vivo trials, and one-third reported on clinical applications. The overall majority of the reactions were mild in more than half of the investigations. Symptoms of extreme and extensive FBR mainly include osteolysis, ganglion cysts, and swelling. The localization of PLLA implants in bone can often result in osteolysis due to local acidosis. This issue can be mitigated by adding hydroxyapatite. There should be no strong FBR when PLLA is fragmented to 0.5\u20134 \u00b5m by extracorporeal shock wave.<\/jats:p>","DOI":"10.3390\/polym16060817","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T14:05:25Z","timestamp":1710511525000},"page":"817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Potential for Foreign Body Reaction of Implanted Poly-L-Lactic Acid: A Systematic Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4529-3159","authenticated-orcid":false,"given":"Melanie","family":"Nonhoff","sequence":"first","affiliation":[{"name":"Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4943-3398","authenticated-orcid":false,"given":"Jan","family":"Puetzler","sequence":"additional","affiliation":[{"name":"Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5334-5171","authenticated-orcid":false,"given":"Julian","family":"Hasselmann","sequence":"additional","affiliation":[{"name":"Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Materials Engineering Laboratory, Department of Mechanical Engineering, University of Applied Sciences Muenster, 48565 Steinfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Fobker","sequence":"additional","affiliation":[{"name":"Central Laboratory, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gosheger","sequence":"additional","affiliation":[{"name":"Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2899-1558","authenticated-orcid":false,"given":"Martin","family":"Schulze","sequence":"additional","affiliation":[{"name":"Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/0278-2391(87)90194-7","article-title":"Resorbable poly(L-lactide) plates and screws for the fixation of zygomatic fractures","volume":"45","author":"Bos","year":"1987","journal-title":"J. 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