Massive and Irreparable Rotator Cuff Tears

Part 1 Basic science.- Massive and irreparable rotator cuff tears: defining the problem.- Biology of rotator cuff injury and repair.- Biomechanics of rotator cuff repair.- Re-rupture or non-healing? Factors determining an unsuccessful repair.- Biological augmentation in rotator cuff repair: growth factors.- Biological augmentation in rotator cuff repair: cell therapies.- Biological augmentation in rotator cuff repair: scaffolds.- Imaging of repaired rotator cuff.- Part 2 Controversies in massive rotator cuff tears.- Clinical outcome vs structural integrity: what really matters?.- Fatty infiltration and muscle atrophy: what it means and what happens after repair.- Pseudoparalysis: Pathomechanics and clinical relevance.- Rotator cuff tear arthropathy: where are the limits for repair?.- Suprascapular nerve release: fact or fiction.- Traumatic cuff tears: the relevance of timing.- Critical shoulder angle: doeslateral acromioplasty have a role in preventing re-rupture.- Shoulder injections: options, ultrasound assistance, evidences.- Non-operative Treatment: The Role of Rehabilitation.- Patient Expectation in the treatment of rotator cuff tears: what is it's role?.- Treatment of massive irreparable cuff tears: decision-making process.- Part 3 Surgical techniques.- Partial repair.- Patch Graft Augmentation.- Superior capsule reconstruction.- Postero-superior Massive Irreparable Rotator Cuff Tears: The Biceps Autograft.- Tendon Transfer for Posterosuperior Cuff: Latissimus Dorsi Transfer.- Tendon Transfer for Posterosuperior Cuff.- Tendon Transfer for Posterosuperior Cuff: Latissimus Dorsi Transfer.- Tendon transfer for anterosuperior cuff: The Pectoralis Major Transfer.- Tendon transfer for anterosuperior cuff: Latissimus Dorsi Transfer.- Subacromial spacer.- Regional blocks and opioid sparing anesthesia: helping the surgeon

Nuno Sampaio Gomes, MD, MSc, is Clinical Director of the Orthopaedic Department at Porto Military Hospital in Portugal, where he has been an orthopaedic surgeon since 2006. He also works in private practice at Hospital da Luz and has been in charge of the shoulder and elbow surgeries in the public hospital of Póvoa de Varzim since 2006. Dr. Gomes graduated from the Medical School of Porto University in September 1996 and gained a Master's degree in Sports Medicine from the same university in 2001. He subsequently undertook clinical fellowships in Macau, France and Spain and completed his residency in Orthopaedics in 2006. Dr. Gomes has served as a board member of the Shoulder and Elbow Section of the Portuguese Society of Orthopaedics and Traumatology (SPOT) for several years and is currently board member and Chairman for Education in the European Shoulder Associates of ESSKA. He is also an Associate Member of SECEC and ISAKOS and has published a number of scientific articlesin indexed journals and collaborated in book projects, besides being a regular reviewer for indexed publications and faculty on international training courses.


Ladislav Kovacic, MD, is an orthopaedic trauma surgeon in the Clinical Department of Traumatology, University Medical Center Ljubljana, Slovenija. This institution is the largest and leading hospital in the country. It accepts patients from elsewhere in Slovenija and neighboring countries. Dr. Kovacic graduated from the Medical Faculty, University of Ljubljana, in 2000 and completed specialization in Traumatology in 2007, when he took up his present position. He also spent one year, 2016, working as orthopaedic and trauma surgeon in France. His professional focus of interest are intraarticular fractures, joint injuries, articular and periarticular pathology, sports traumatology and arthroscopic surgery. For the last few years, he is mainly involved in the treatment of shoulder pathology, performing openand