Are there alternative treatments for shoulder replacement? If the cartilage is completely worn in the capsule, is replacement the only remedy?

When the cartilage in the shoulder joint is completely worn out, usually significant or often severe pain is present, as well as decreased function.

Usually, management of the pain has the highest priority. This may involve medication by mouth (Acetaminophen, NSAID, narcotics, other) or by joint injection (typically cortisone type medication.). On occasion, some temporary benefit can be derived from arthroscopic smoothing of the joint surface.

Joint replacement involves replacing one or two surfaces ('ball and/or socket') with a smooth surface, metal or plastic. This reduces pain, while allowing motion. These mechanical devices are subject to wear and tear, and may fail.

Shoulder fusion eliminates motion. Usually this is associated with good pain relief, at the expense of range of motion. Strength, however, is quite good. The arm can still be positioned with the shoulderblade. This is a big operation and its use has declined in recent years.

As a last resort, the shoulder joint can be excised in its entirety. This leads to a flail arm. This is not utilized very often as a first procedure.

Currently, more biological options are not readily available.