The growth and development of the musculoskeletal system is a complex process mediated by biological and mechanical factors that produce isolated tissues with differential properties. Together, the tissues of the musculoskeletal system join to produce the body’s form and structure while providing stability and movement capabilities. During maturation, genetics, nutrition, hormones, and mechanical forces drive the tissues of the musculoskeletal system to transform with temporal specicity. These factors individually and collectively produce changes that alter the constituent makeup of the tissue, its morphology, and its biomechanical response. This chapter aims to detail the biomechanical effects of growth and development both on isolated musculoskeletal tissues and on the system as a whole. This review chiey focuses on typical development and its effects on orthopaedic biomechanics. Bone, ligament, tendon, intervertebral disc, cartilage, and skeletal muscle ontogeny are individually discussed as well as their integration into the complete musculoskeletal system. Basic maturation biology and biochemistry are presented to contextualize the changes in tissue morphology, size, and biomechanics. The effects of growth and development are discussed because they pertain to the integrated musculoskeletal system

CONTENTS

12.1 Biological Review of Musculoskeletal System Growth and Development ...............330 12.1.1 Bone ......................................................................................................................... 331 12.1.2 Soft Connective Tissue .......................................................................................... 332 12.1.3 Skeletal Muscle .......................................................................................................334