Accurate glenoid component placement continues to be a challenge. Knowledge that glenoid loosening is affected by malpositioning of the glenoid component has led to the development of patient specific instrumentation (PSI) in an attempt to optimise glenoid positioning. The ideal PSI would be reusable, reliable, cost-effective and robust enough to tolerate the stresses applied by the surgeon in the context of difficult glenohumeral exposure. The VIP system is a CT scan-based PSI with a reusable instrument. The subtle nuances of pre-operative planning will be discussed in a separate short video. The live surgery will incorporate use of the patient specific instrumentation during glenoid placement and the use of a short stemmed fourth generation total shoulder arthroplasty