Although the xray may show significant arthritis, some patients have surprisingly good (and functional) motion, but pain above shoulder level is the problem. In these types of situations, in which pain is the primary problem and motion is okay-----shoulder arthroscopy may be an alternative to "replacement". The biceps long head tendon is frequently degenerative, and as such, a pain mediator. In addition, loose bodies can be removed, and   partial tears of the rotator cuff and bursitis can be addressed with arthroscopic debridement and acromioplasty. The net result may be pain relief, and, at the very least, one may "buy some time" prior to needing a replacement. The advantages of this approach--assuming it is an option---is a quicker recovery and less surgery, without burning any bridges. However, if shoulder motion is limited---no motion above shoulder level, and limted rotation-- this is probably not going to help.

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