ObjectiveTo review the research progress and challenges of poly (L-lactic acid) (PLLA) membrane in preventing tendon adhesion. MethodsThe relevant literature at home and abroad in recent years was extensively searched, covering the mechanism of tendon adhesion formation, the adaptation challenge and balancing strategy of PLLA, the physicochemical modification of PLLA anti-adhesion membrane and its application in tendon anti-adhesion. In this paper, the research progress and modification strategies of PLLA films are systematically reviewed from the three dimensions of tissue adaptation, mechanical adaptation and degradation adaptation. ResultsThe three-dimensional fitness of PLLA membrane is optimized by combining materials (such as hydroxyapatite, polycaprolactone), structural design (multilayer/gradient membrane), and drug loading (anti-inflammatory drug). The balance between anti-adhesion and pro-healing is achieved, the mechanical fitness is significantly improved, and degradation fitness achieved (targeting the degradation cycle to 2-4 weeks to cover the tendon repair period). ConclusionIn the future, it is necessary to identify the optimal balance point of three-dimensional fitness, unify the evaluation criteria and solve the degradation side effects through the co-design of physicochemical modification and drug loading system to break through the bottleneck of clinical translation.