WG asks: I am a 56-year-old active golfer who has had shoulder pain for the past five years.

I have seen an orthopedic doctor who has tried physical therapy and injections with no significant relief. I also have had an X-ray which showed I have a lot of arthritis in my shoulder joint. My shoulder MRI only showed I have a lot of arthritis in my joint, but no evidence of a rotator cuff tear.

My range of motion is very limited and painful with golfing and now even with some basic activities. My surgeon told me I need a total shoulder replacement. What are my options?

Dr. Patel writes: Dear WG, it sounds as though you have arthritis in the shoulder joint. As the arthritis progresses, the range of motion can significantly decrease. The pain can get worse as the cartilage wears down on the joint. The capsule around the shoulder can also get tight which can decrease the motion of the shoulder. You are very young to have this amount of arthritis of the shoulder.

The most conservative treatments to try first are injections and physical therapy. Unfortunately, this will not resolve the problem. You have tried that without any relief and I believe you are approaching the need of surgery for relief.

In terms of surgery, I think you have some options. The option given to you for a total shoulder replacement is one option.

A total shoulder replacement involves replacing the ball with a metal ball after the original ball is cut off and replacing the socket with a plastic socket. This is a good option, but long-term studies have shown the socket loosens over time and has a higher frequency of failure in younger patients.

The second option is a procedure I perform and was fellowship trained in. It’s called a shoulder resurfacing.

A resurfacing involves only shaving down the ball enough that a metal cap is placed on the ball. The ball is not cut off. The socket is left alone as long as the bone quality is good.

This procedure has limited chance of loosening and can last a lot longer for an active individual like yourself. This procedure can also help control the pain you have from the arthritis. I would recommend you get evaluated for a shoulder resurfacing as well.