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Late Foreign-Body Reaction After Treatment of Distal Radial Fractures with Poly-L-Lactic Acid Bioabsorbable ImplantsA Report of Three Cases
Chih-Yu Chen, MD1; Chih-Hao Chang, MD3; Yung-Chang Lu, MD4; Chih-Hung Chang, MD, PhD2; Chien-Chen Tsai, MD2; Chun-Hsiung Huang, MD4
1 Department of Orthopaedic Surgery, Taipei Medical University Shuan-Ho Hospital, No. 291, Jhongjheng Road, Jhonghe City, Taipei County 235, Taiwan.
3 Orthopaedic Department, National Taiwan University & Hospital, No. 7, Chung Shan S. Road, Taipei 100, Taiwan.
4 Department of Orthopaedic Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Chung-San North Road, Taipei 10449, Taiwan. E-mail address for C.-H. Huang: chhuang1230@gmail.com
2 Orthopaedic Division, Surgery Department (C.-Y.C. and C.-H.C.), and Clinical Pathology Department (C.-C.T.), Far Eastern Memorial Hospital, No. 21, Nan-Ya S. Road, Sec. 2 Pan-Chiao, Taipei, Taiwan. E-mail address for C.-H. Chang: orthocch@gmail.com
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at Far-Eastern Memorial Hospital, National Taiwan University & Hospital, and Mackay Memorial Hospital, Taipei, Taiwan

Copyright © 2010 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Nov 17;92(16):2719-2724. doi: 10.2106/JBJS.I.01761
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Since the 1980s, bioabsorbable implants have been increasingly utilized for fracture fixation and also for other orthopaedic procedures, including ligament reconstruction, meniscal repair, rotator cuff repair, and shoulder labral lesion repair1-4. The majority of bioabsorbable materials for implants are monopolymers or copolymers of polylactic acid (PLA) (including a levorotatory [PLLA] and a dextrorotatory [PDLLA] configuration), polyglycolic acid (PGA), and polydioxanone (PDS)3,4. The foreign-body reactions related to polyglycolic acid usually have emerged one to four months after implantation and have been well documented in the literature1,3,5. However, the in vivo degradation time of the stereoisomeric form of polylactic acid copolymers is much longer6. In contrast to polyglycolic acid, the tissue responses associated with polylactic acid (PLLA or PDLLA) are much less common5.
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