International Shoulder and Elbow Surgery Expert Dr. Guerra’s Memorable Visit to Nanchang Hongdu Hospital of Traditional Chinese Medicine(TCM)

From October 20 to 24, Dr. Enrico Guerra, an international expert in shoulder and elbow surgery, visited Nanchang Hongdu Hospital of Traditional Chinese Medicine(TCM) and conducted a series of academic exchange activities, including outpatient consultation, ward rounds, surgical guidance, departmental training, difficult cases discussion and public lectures, etc. Dr. Guerra is the Director of the Shoulder and Elbow Surgery Department and the Acting Head of the Emergency Department at Rizzoli Orthopaedic Institute, Bologna, Italy. He is also the Member of Italian Society of Shoulder and Elbow Surgery (SICGeS) and the Italian Society of Orthopedics and Traumatology (SIOT).

Welcome Ceremony

On the morning of October 20, a warm welcome ceremony was held for Dr. Guerra at Nanchang Hongdu Hospital of Traditional Chinese Medicine (TCM). Prof. FAN Shaoyong, Member of the Party Committee; Prof. ZHOU Ming, Director of the Sports Medicine Department; Doctor HOU Huiming, Deputy Chief Physician; Ms. LIU Dan, Head Nurse of the department; and other medical staff warmly greeted Dr. Guerra and presented him with a bouquet of fresh flowers to express their sincere welcome.

At the welcome ceremony, Prof. FAN Shaoyong gave a brief introduction of Nanchang Hongdu Hospital of Traditional Chinese Medicine(TCM): the hospital was established in 1957. It is a Class III Grade A hospital of Traditional Chinese Medicine which integrates medical service, education, scientific research, prevention, and healthcare. The hospital is renowned for its distinctive specialties, supported by strong technical capabilities. It is dedicated to building a portfolio of the eight key brands, notably including “Hongdu Orthopedics and Traumatology”, “Hongdu Traditional Chinese Medicine,” and “Hongdu Rehabilitation”. 

Then, Prof. ZHOU Ming provided an overview of the Sports Medicine Department, which operates under the tenets of “Precision Minimally-Invasive Surgery, Function First, Early Rehabilitation, and Return to Exercise”. The department is characterized by its emphasis on functional recovery and the predominate use of arthroscopic techniques. It is specialized in the diagnosis, treatment and rehabilitation of various joint diseases, sports injuries and other musculoskeletal disorders.

After that, Dr. Guerra introduced Bologna, the Rizzoli Orthopaedic Institute and its Shoulder and Elbow Surgery Department. Dr. Guerra shared that Bologna is an old and beautiful city where the time-honored University of Bologna was located. The Rizzoli Orthopaedic Institute is the largest orthopedic center in Bologna—and indeed in northern Italy—integrating three core functions: clinical services, scientific research, and education. It employs nearly one hundred orthopedic specialists, has 398 beds, and performs an average of 14,000 surgeries each year. The Shoulder and Elbow Department was established in 2000. It receives over 2,000 patients annually, more than half of whom are trauma patients. The department specializes in the diagnosis and treatment of shoulder, elbow, and forearm disorders. In addition, it places great emphasis on academic exchange and international collaboration. Every six months, groups of doctors from around the world visit the department for observation and professional training.

At the end of the ceremony, the hospital leadership, Dr. Guerra, and the other attending doctors took group photos as a memento. Afterwards, Prof. FAN and Doctor HOU accompanied Dr. Guerra on a tour of the Acupuncture Department, the Rehabilitation Center, and the Department of Sports Medicine.

Internal Department Lecture

On the afternoon of October 20, Dr. Guerra held a discussion with the department team, during which he delivered a lecture titled “Rotator Cuff Tear”. The session attracted an enthusiastic audience composed of surgeons, postgraduate students, and interns from the department , creating a lively and engaging atmosphere. Dr. Guerra’s lecture began with an overview of rotator cuff anatomy, epidemiology, and the underlying causes-both intrinsic and extrinsic factors-followed by a detailed discussion on the classification and morphology of rotator cuff tears. He then elaborated on various surgical techniques for rotator cuff repair and approaches to reducing the rate of re-tear after surgery. At the end of the lecture, the young doctors actively raised questions, creating a dynamic and highly interactive atmosphere.

Masterclasses

On October 21, Dr. Guerra was invited to attend the Special Seminar of Jiangxi Clinical Research Base for Tendon and Ligament Injuries and the fifth Graduate Student Reading Club. He conducted three masterclasses. A large number of doctors and medical graduate students attended, and the auditorium was full. In the morning, Dr. Guerra shared a lecture titled “Rotator Cuff Tears.” He first summarized with the attending graduate students the function, anatomical structure, biomechanical principles of the rotator cuff, and types of rotator cuff tears, and then further shared corresponding intervention strategies. Dr. Guerra emphasized that tissue quality is crucial for rotator cuff stability; during rotator cuff repair, reducing retear rates while paying attention to postoperative function and range of motion recovery is also very important. During the discussion session, an audience mentioned occasional pain in her right shoulder. Dr. Guerra invited her to the stage for immediate palpation, and explained that her shoulder joint was slightly lax and weak, and advised her to maintain muscle balance. Taking this opportunity, Dr. Guerra stated that pain intervention requires not only identifying the cause, but also considering the body as an integrated whole, a philosophy that closely resembles the Chinese traditional massage concept of “Eight-and-a-Half Lock.”

In the afternoon, Dr. Guerra lectured on “Shoulder Instability: A Still Open Question.” He systematically reviewed the shoulder anatomy and classified shoulder dislocations based on different pathomechanisms; he then detailed the types of soft tissue and bony injuries of the glenoid and humeral head, and discussed various surgical strategies ranging from traditional repair to advanced techniques, including Bankart repair, Latarjet procedure, Remplissage, arthroscopic subscapularis augmentation, bone block grafting, and J-shaped grafting. During the discussion session, Prof. ZHOU Ming, Director of the Sports Medicine Department and Dr. Guerra conducted an in-depth discussion on the technical details of biceps tendon fixation. Department doctors showed strong interest in the J-shaped graft and requested further technical guidance from Dr. Guerra. At the end of the lecture, both sides engaged in a heated discussion on Latarjet surgical details, including handling of the pectoralis minor and coracoacromial ligament, creating a highly stimulating academic atmosphere.

Subsequently, Dr. Guerra provided a detailed lecture on the complete procedure of “Arthroscopic Elbow Release,” covering preoperative assessment and positioning, portal design, arthroscopic key points, and postoperative rehabilitation management. The professor first introduced the principles of choosing surgical positions, emphasizing the need to select the optimal portal and arthroscopic entry angle according to the lesion scope and surgeon preference; he then demonstrated step-by-step release techniques of the anterior and posterior joint capsule, highlighting the layers and safety limits when removing scar tissue and osteophytes. For high-risk intraoperative areas, Dr. Guerra particularly emphasized identifying and mobilizing the ulnar nerve to prevent traction or injury. Finally, he explained postoperative drainage management, early functional exercises, and strategies to prevent joint adhesions, systematically demonstrating a standardized and refined approach to arthroscopic elbow release.

Ward Rounds and Surgical Guidance

On October 22, Prof. ZHOU Ming, Director of the Sports Medicine Department, together with Dr. Guerra and several doctors, conducted ward rounds. During the rounds, Prof. ZHOU and Dr. Guerra carefully reviewed the rehabilitation progress of inpatients, patiently answered patient questions, and analyzed preoperative and postoperative MRI images together. Dr. Guerra commented that the department demonstrates excellent professional capability and rich clinical experience in the diagnosis and treatment of shoulder, elbow, knee, hip, and ankle disorders, leaving a deep impression.

Following the rounds, Prof. ZHOU Ming invited Dr. Guerra to visit the operating rooms and provide surgical guidance on specific cases. The first surgery was arthroscopic elbow release. Before the operation, Dr. Guerra carefully analyzed the patient’s MRI images and shared his insights and suggestions with the surgical team. During the procedure, Prof. ZHOU consulted Dr. Guerra on patient positioning and portal selection, and both sides engaged in thorough exchanges. Postoperatively, they further discussed rehabilitation strategies and individualized treatment plans. Additionally, Dr. Guerra observed two knee surgeries, including patellar tendon repair and ACL reconstruction with artificial ligament. After the observation, Dr. Guerra highly praised Prof. ZHOU’s surgical skills, noting precise suturing and accurate reconstruction. Both experts also demonstrated strong alignment and professional rapport in postoperative rehabilitation planning.

Outpatient Activities

On October 23, Prof. ZHOU Ming, Director of the Sports Medicine Department, conducted outpatient activities and invited Dr. Guerra to jointly consult patients. The day’s cases included postoperative follow-up patients for rotator cuff repair, meniscus injuries, posterior knee cysts, lumbar disc herniation, sciatica, ankle fractures, cervical pain, and hip degenerative lesions with cysts. During consultations, Prof. ZHOU and Dr. Guerra attentively listened to patient complaints and treatment feedback, carefully analyzed MRI and CT images, and engaged in in-depth discussion on treatment approaches. Dr. Guerra noted that intervention after joint injury should prioritize active rehabilitation to promote recovery of joint mobility. Both orthopedic experts shared highly consistent views on conservative treatment and functional rehabilitation.

Closing Ceremony

On October 24, Dr. Guerra held a masterclass in the Sports Medicine Department conference room, titled “Department Management: How to Be a Good Leader?” Attendees included Prof. FAN Shaoyong, Member of the Party Committee; Prof. ZHOU Ming, Director of the Sports Medicine Department, and the Sports Medicine team. During the lecture, Dr. Guerra systematically explained the basic concepts of management and analyzed the commonalities between general management and departmental leadership. He emphasized that becoming an excellent leader requires not only the ability to endure solitude and pressure, but also patience, resilience, and self-reflection. He further noted that the essence of leadership lies in teamwork: without a strong team, a true leader cannot exist.

Based on his own experience, Dr. Guerra shared management insights as a department head: respect diseases, as they may confuse doctors; care for patients, who need more than treatment plans but also attention and support; understand colleagues’ mistakes, as everyone makes errors; reflect on one’s own mistakes to avoid repeating them. He also shared guidance from his father, who was also an excellent orthopedic expert, expressing the hope of passing this spirit on to the Sports Medicine team to motivate continuous development.

After the lecture, Both Prof. FAN and Prof. ZHOU expressed that they gained resonance and inspiration from the lecture and admired Dr. Guerra’s medical dedication. Both parties then took commemorative photos and expressed active expectations for future Sino-German academic exchanges in sports medicine and shoulder and elbow surgery.