I went through the whole gamut from steroid/ local anesthetic injections, cartilage injections, and finally total replacement. You will know when it's time because you can't sleep at night for the pain. Post-op your shoulder will be immobilized completely for a month other than supervised PT. IT is a slow process over several months to regain strength and range of motion. Success is determined by how hard you work. Replacement is one of the best decisions I've made, because now I do what I want with NO pain.