Hi Pedro,
Thank you and all others for advice and kind words.
The accident 5 years ago has completely torn-off one of my 4 rotator cuff tendons, so my shoulder now hangs on 3.
As you said, it is too late to do any repairs now, and I very much regret I did not do it when the injury was repairable and I had health insurance.
I have not done the MRI for the recent accident - my current US "Health Insurance" does not pay for MRI (and most other things too) and I don't have the $1,200 to pay myself. However, I am cautiously optimistic that this time the damage may be not so bad. My shoulder made big progress since the accident 2.5 weeks ago. I have almost full range of motion, the pain is much less, and much of the strength returned. The only thing I still cannot do is to reach high overhead with my left arm, but even this is improving.
I am concerned about this statement you've made:
: With time, that increased movement can cause degenerative problems with the
: cartilage that lines the joint. In other words, early arthritis.
I wonder if good program of strengthening exercises and physical therapy might help in this area?
Regards

: Hi Skiffrace,

: I haven't read all the other responses, so if I repeat something that's been
: said already, I apologize.

: Do you have a copy of the MRI results from the first injury? Which tendon was
: damaged the first time? Was it the supraspinatus tendon? That's the most
: commonly injured tendon in the shoulder, it's one of four tendons that
: make up the infamous rotator cuff. Was it a complete tear or a smaller
: partial tear?

: If you had a complete tear 5 yrs. ago and did not have it repaired, it
: probably won't be repairable now. If it was a partial tear which healed,
: to some extent, on its own, you have much better chances of repairing it
: now. From what you said in your post, I'm guessing it was a partial tear.

: It sounds like you are a pretty active person, is that right? If you're an
: active person and you plan to remain active, I wouldn't advise you to skip
: surgery again. If you have a tear that can be repaired, repair it. The
: shoulder joint is a very shallow ball and socket. Shoulder stability is
: mainly provided by the musculature and ligaments around the shoulder. If
: that stability is compromised by a torn tendon or ligament, the joint
: often slides around more than normal during movement. With time, that
: increased movement can cause degenerative problems with the cartilage that
: lines the joint. In other words, early arthritis.

: I won't blow smoke, shoulder surgery isn't fun. It's not exactly a painless
: recovery, but it's usually the best way to go.

: I could tell you to take up a safer sport than cycling, but it wouldn't make
: much sense coming from me...I fly hang gliders.

: Keep us posted on the MRI results and the doctor's recommendations.

: Pedro Almeida