Shoulder-related disorders are highly prevalent, with the global incidence being on the rise. Neuromuscular rehabilitation aims to optimize muscle function and motor performance by modulating the neuromuscular system, which comprises the central and peripheral nervous systems. This study aimed to synthesize evidence on neuromuscular rehabilitation for shoulder disorders, evaluating its effects on pain, range of motion, and shoulder function. English-language literature was retrieved from the PubMed, Cochrane, and Embase databases up to June 2025 via search terms such as "Shoulder," "Neuromuscular," and "Rehabilitation". The inclusion criterion was randomized controlled trials that used neuromuscular rehabilitation techniques for shoulder diseases. The primary outcome was pain improvement, and secondary indicators included joint range of motion and function. The effect size was the standardized mean difference (SMD) and 95% confidence interval (CI). Heterogeneity was evaluated via I2. Neuromuscular therapy significantly reduced pain (SMD [95% CI] = -2.82 [-4.79, -0.85]), with greater improvements than did the control (SMD [95% CI] = -0.75 [-1.35, -0.15]). Improvements were observed in shoulder flexion, extension, abduction, and external rotation, with external rotation showing the most significant benefit versus controls. Neuromuscular therapy improved functional scores (SMD [95% CI] = -1.95 [-3.71, -0.19]) and outperformed the control (SMD [95% CI] = -0.65 [-1.25, -0.05]). This study revealed that neuromuscular physical therapy can effectively relieve pain in patients with shoulder disorders, improve joint mobility, and enhance function. These findings support its use as an adjunctive therapy in conventional rehabilitation.

An intraosseous pneumatocyst is a gas-containing cystic bone lesion that is not associated with infection or bone necrosis due to vertebral compression fracture. The most common sites are the pelvis and spine, but it is reported rarely in other sites. To our knowledge, only two cases of intraosseous pneumatocyst in the scapula have been reported. Herein, we report two cases of intraosseous pneumatocyst of the scapula, in a 41-year-old woman and a 51-year-old man. Neither patient had shoulder symptoms, and the lesions were found incidentally during imaging studies. Plain X-rays revealed cystic lesions with sclerotic rims, located from the scapular neck to the glenoid, adjacent to the shoulder joint. Plain X-rays of the 51-year-old male patient showed osteoarthritis of the shoulder, including joint space narrowing and osteophyte formation. CT was used for diagnosis in both cases. The patients remained pain-free throughout the follow-up period (10 years and 6 months, respectively). Their lesion sizes were unchanged, and radiolucency was reduced at the final follow-up. The shoulder joint has the largest range of motion in the human body; thus, the vacuum phenomenon may occur when the shoulder is elevated or externally rotated. We speculate that gas was produced in an intraosseous ganglion or subchondral cyst, the likely pre-existing lesions, after the vacuum phenomenon occurred in the shoulder joints of these patients.

The use of orthobiologic augmentation, including platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), has gained increasing attention in rotator cuff repair; however, evidence supporting their combined use remains limited and inconsistent. This prospective randomized controlled study evaluated the clinical efficacy of PRP and combined PRP with BMAC (BMAC + PRP) following arthroscopic repair of large full-thickness rotator cuff tears (3-5 cm). A total of 93 patients were allocated into three groups: control (n = 33), PRP (n = 30), and BMAC + PRP (n = 30). Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score (primary outcome), visual analogue scale (VAS), and Constant score at baseline, 3 months, and 6 months. To address baseline imbalances, propensity score-based overlap weighting (ATO) and weighted ANCOVA were performed. All groups demonstrated significant improvement in pain and functional outcomes over time. In unadjusted analyses, early differences were observed at 3 months; however, after adjustment using overlap weighting and baseline covariates, no statistically significant differences were observed between groups at 6 months for ASES, VAS, or Constant scores. Exploratory age-stratified analyses suggested potential trends toward improved outcomes in patients aged > 55 years in the BMAC + PRP group, although these findings were attenuated after adjustment and should be interpreted cautiously. These findings indicate that, despite theoretical biological complementarity, the addition of BMAC to PRP does not confer clinically meaningful short-term benefit after repair of large rotator cuff tears. The results challenge the assumption of additive efficacy in combined orthobiologic strategies and underscore the need for biologically stratified trials to identify patient subsets that may derive benefit. Longer-term and mechanistically integrated studies are required to define the role of combined biologic augmentation in tendon regeneration.Trial registration: The patients were registered in the institutional board registry of Hallym University Medical Center (registry number 138-82-02667). The study was registered with the International Standard Randomized Controlled Trial Number (ISRCTN) 69,088,783.