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Is it enough level 1 data? To say that the Regeneten offers superior outcomes? compared to just repair alone? Yes, it is weak point of these studies You are right So we requires randomized control study for the patient. Still lots of the institute try to such a study So, as a practitioner I clearly bet it, the result would be at least better. I cannot say it would be best choice, but at least could be better more good choice than previous simple repairs procedure Even though it requires something cost procedure And what is your take on PRP for a conservative treatment? If you're doing non-surgical treatment, what is your take on PRP? Yes The major Effectiveness of PRP would be provide anti-inflammatory effect Additionally, promote vascularity and the healing mechanism. in case of the stiffness or minor rotator cuff tear- And if patient do not want surgery even there has a obvious rotator cuff tear, in such a case, only PRP injection, in outpatient clinic also provide sufficient result. Do you use in your practice, PRP? Yes, more than several thousand cases, Thank you What is your take on massive rotator cuff tears? Large tears, massive tears which are irreparable, What is your solution? Or, do you go for muscle transfers or you do for superior capsule reconstruction? What is your take? In case of massive or large cuff tear, I am dividing into two part The one, patient can functionally elevate his or her arm properly, in such a case, I try to partial repair or patch graft, or repair and augmented with BioBrace or Regenaten So I try to repair as much I can If patient cannot, available for abduction properly, it is keep going, maybe, I try to wait at least 1 or 2 months If patient still unable to moving arm properly, then my comment is let's go for the reversible surgery, arthroplasty You prefer an arthroplasty? Yes What is your take on the lower trapezius transfer? There's a lot of interest in lower trapezius transfer, right? I know, some surgeon prefer such a procedure, but some surgeon criticizing a little aggressive with surgeries because trapezius muscle is not only useful for scapular movement but also useful for breathing And, there are some, Dr. Park from Korea also did the long head biceps tendon Right? Dr. Park and lots of doctor, like this procedure utilizing biceps rerouting. They use biceps as a cable, right? Function in aged person, flexion and extension is depend on the short head of biceps Long head of biceps can be re-utilized as supporting rotator cuff tendons So it is smart idea. Thank you, Professor Thank you for this wonderful presentation- great, discussion Thank you