This book offers a truly comprehensive overview of the understanding and treatment of massive and irreparable rotator cuff tears, a painful and disabling shoulder condition that continues to pose major challenges. A thorough examination of basic science issues and evidence lays the foundation for discussion of key controversies in the field and exposition of a practical approach to treatment in which the role of both conservative and surgical management is explained. Special insights are provided into the new biological and nonoperative approaches that are becoming increasingly popular among practitioners. All potential surgical techniques are described, from partial repair and tendon transfer, to the use of dedicated implants. In addition, the value of anesthesia and regional blocks, both during surgery and in the postoperative phase, is discussed. The concluding section addresses particularly complex scenarios and offers guidance on the management of treatment complications and failures. Written by leading international shoulder experts, the book will be of value for shoulder surgeons, rehabilitators, and other health care practitioners.