Is it in the AC joint or the glenohumeral (ie labrum damage)?
If it's the AC joint they can "clean it out" by shaving off part of the collar bone.
If it's glenohumeral then there really isn't much else you can do aside from a replacement.
I'd continue with the PT for a while and if you aren't happy try a different therapist. If you already have good strength then you're probably right that it won't help much, but a good PT may identify some imbalances that are causing some impingement.
I'm half your age and dealing with it already. I had surgery the beginning of this year on that side. We initially thought I had two separate labrum tears, but it turned out to be one posterior tear and arthritis along the front top that resembled a SLAP tear on the MRI. My hope is to keep mine healthy enough that I never have to go through a replacement, but either way that's a long ways off for me.