Polylactic acid (PLA) is a well-known biomaterial on account of its biocompatibility and biodegradability. Zinc oxide (ZnO) nanofillers may endow PLA with advantageous antibacterial and tissue regenerative properties, but may also compromise the biocompatibility of PLA. Several strategies have been developed to improve the biomedical practicality of such composites. The importance of surface properties on amplifying the therapeutic properties and safety of a material enables two potential strategies: (i) surface modification of ZnO nanoparticles, and (ii) surface engineering of the PLA/ZnO composites. Moreover, the controllable biodegradation of PLA allows a third possible strategy: (iii) biodegradation-controlled release of ZnO. The first part of this review introduces the controllable degradation of PLA and the mechanisms of therapeutic properties and cytotoxicity of ZnO. Following this, the paper highlights current research trends regarding the biomedical application of PLA-based ZnO nanocomposites. The final section of this review discusses the potential use of ZnO in tuning the degradation rate of PLA, and the possibility of manipulating the surface properties of ZnO nanoparticles and PLA/ZnO composites in order to optimize the therapeutic properties and safe usage of PLA/ZnO composites in the biomedical field.
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