116: RSA Design + Concepts w/ Dr. Kassam

In this episode, we’re joined by Dr. Kassam to explore the origins and evolution of Reverse Shoulder Arthroplasty (RSA), from its early rationale in treating RTC arthropathy to the groundbreaking Grammont design. We discuss the core components of RSA, the critical role of center of rotation (COR), glenoid and humeral lateralization, and their impact on biomechanics. We also talk about surgical considerations like scapular notching prevention, baseplate positioning, inlay vs onlay humeral stems, and the significance of neck-shaft angles.

Dr. Hafiz Kassam is a board-certified orthopedic surgeon specializing in shoulder reconstruction. He serves as HOI’s medical director of shoulder reconstruction.

Dr. Kassam has extensive experience in complex shoulder and elbow reconstruction and sports injuries. Dr. Kassam pursued his education and training at world-class institutions in three countries. After completing his undergraduate work and medical training in the United Kingdom, he completed his residency at the University of Toronto, which is one of the largest and most academically productive programs in North America. He then moved to the USA and completed his shoulder and elbow fellowship training at Yale University. He is an expert in minimally invasive techniques in shoulder and elbow joint replacement as well as advanced arthroscopy, traumatic reconstruction and non-operative treatments. He has performed more than 1,000 shoulder replacements and arthroscopic reconstructions in his career so far.

Believing in evidence-based choices for his patients and improving outcomes in modern orthopedics, Dr. Kassam is a well-published clinician-scientist. He has authored numerous original scientific research studies, technique guides, and textbook chapters, presenting his work on both the national and international stages. He is the program chair for the Northern California Shoulder and Elbow Course and sits on the Editorial Board for the Journal of Shoulder and Elbow Arthroplasty.

Goal of episode: To develop a baseline knowledge of RSA design.

In this episode, we provide answers to questions you may have on reserve shoulder arthroplasty, like:

• What was the original reason for RSA?

• What are the basic components of an RSA? 

• What is the importance of COR with regard to RSA?

• What is glenoid lateralization, and of what importance is it?

• Does it matter where you get your lateralization from?

• Is inferior placement of the baseplate on the glenoid a good thing to do?

• And much more!