The 2010 Hans Cloos lecture : the contribution of urban geology to the development, regeneration and conservation of cities

Urban geology began to develop in the 1950s, particularly in California in relation to land-use planning, and led to Robert Legget publishing his seminal book “Cities and geology” in 1973. Urban geology has now become an important part of engineering geology. Research and practice has seen the evolution from single theme spatial datasets to multi-theme and multi-dimensional outputs for a wide range of users. In parallel to the development of these new outputs to aid urban development, regeneration and conservation, has been the growing recognition that city authorities need access to extensive databases of geo-information that are maintained in the long-term and renewed regularly. A further key advance has been the recognition that, in the urban environment, knowledge and understanding of the geology need to be integrated with those of other environmental topics (for example, biodiversity) and, increasingly, with the research of social scientists, economists and others. Despite these advances, it is suggested that the value of urban geology is not fully recognised by those charged with the management and improvement of the world’s cities. This may be because engineering geologists have failed to adequately demonstrate the benefits of urban geological applications in terms of cost and environmental improvement, have not communicated these benefits well enough and have not clearly shown the long-term contribution of geo-information to urban sustainability. Within this context future actions to improve the situation are proposed

Reliability and validity of the Hartofilakidis classification system of congenital hip disease in adults

The reliability and validity of the Hartofilakidis et al. classification system in adults with congenital hip disease (CHD) were examined. The radiographs of 102 adult patients (158 hips) with CHD were independently assessed by three senior surgeons. Interobserver variability was assessed by examining the agreement between the three raters while validity of the classification system was assessed by examining the agreement between the assessment by either one of the three raters and the intraoperative finding (reference standard). The interobserver agreement between the three observers was high ranging from 0.720 to 0.854 (substantial to excellent) while the agreement of the preoperative prediction with the intraoperative findings was 87.4% (K = 0.823, excellent agreement). The Hartofilakidis et al. classification system reliably predicts from preoperative pelvis radiographs the bone deficiencies encountered during the operation

Impaction grafting of the acetabulum with ceramic bone graft substitute

BACKGROUND AND PURPOSE: Loss of bone stock remains a challenge in revision hip surgery. Grafting with allograft is well established, but there are problems with availability, cost, infection, antigenicity, reproducibility, and stability of the created construct. BoneSave is a biphasic porous ceramic consisting of sintered 80% tricalcium phosphate and 20% hydroxyapatite. In vitro and in vivo studies, including its use mixed with allograft, have shown good results in impaction grafting. This is the first reported series of its use alone in impaction grafting of the acetabulum. METHODS: Methods We conducted a retrospective review of a cohort of 43 consecutive patients undergoing impaction grafting of contained acetabular defects by multiple surgeons at a single centre. All patients received uncemented acetabular components. They were followed up radiographically, together with self-reported satisfaction scale (SAPS), Oxford hip score (OHS), and Short-Form 12 (SF12) health survey. Kaplan-Meier survivorship analysis was performed with revision of the acetabular component, revision of any part of the construct, and reoperation as endpoints. RESULTS: The fate of all cases was known. Mean follow-up was 4 years. 5 patients died during follow-up, with their constructs in situ. The survivorship of the acetabular component was 98% (95% CI: 85–100) at 7 years. 1 acetabular component was revised for infection and there was 1 radiographic acetabular failure. The median OHS was 36 (6–48), the median SF12 PCS was 36 (14–57), the median SAPS was 75 (0–100), and the median SF12 MCS was 50 (23–64). The graft material had incorporated in all 3 zones of the acetabulum in 33 out of 37 cases with complete radiographic follow-up. INTERPRETATION: Medium-term results show that BoneSave alone is a reliable material for impaction grafting of contained defects in the acetabulum at revision surgery