X-Bolt Trauma Orthopedics is a company that brings simplicity and efficiency to trauma surgery, whilst improving quality of life for patients. Pulse 2.0 interviewed X-Bolt Trauma Orthopedics founder and CEO Dr. Brian Thornes to learn more about the company.
Dr. Brian Thornes’ Background
Could you tell me more about your background? Dr. Thornes said:
“I started as an orthopedic surgeon and was trained in Ireland, where the system is somewhat different than the US – we go straight into medical school from high school. This meant I was quite young as a junior doctor, but the training is long and competitive.”
“During this time I had a personal ankle injury from a water-skiing accident that sparked my interest in ankle fractures and led to my research on syndesmosis injuries and the invention of the ankle TightRope. Initially, this work was aimed at advancing my own career in orthopedics, but after conducting a clinical trial with phenomenal results, the TightRope gained commercial traction.”
“I realized I was more drawn to the innovative and commercial aspects of medicine, so I left clinical practice and pursued an MBA. Shortly afterwards, I had the lightbulb moment that led to the X-Bolt device.”
Formation Of The Company
How did the idea for the company come together? Dr. Thornes shared:
“The big problem we’re addressing originates from my experience specializing in orthopedic trauma. As a trainee, I used to think trauma meant high-energy injuries like sports accidents or motor vehicle crashes. However, the reality in hospitals is that 80–90% of orthopedic trauma involves geriatric patients with osteoporotic bone.”
“The equipment for fixing fractures has traditionally been designed for younger, healthier bones, which led me to think about solutions for fragile, osteoporotic bones. The idea for the expandable bolt came while putting up my TV on the wall. I was using an expandable bolt and thought, ‘Why don’t we have something like this for orthopedics?”’
“From the beginning, I knew procedure reversibility had to be a key feature. If anything went wrong, it should be removable without damaging the bone. This design principle has remained central from the initial prototype to the current product.”
Favorite Memory
What has been your favorite memory working for the company so far? Dr. Thornes reflected:
“One standout moment was our participation and attendance at the American Academy of Orthopaedic Surgeons, where we hosted Irish surgeons and celebrated as a company. It felt like a coming-of-age moment, sharing the excitement and camaraderie with peers in San Francisco.”
“However, my absolute favorite memory would be our first surgery. After years of development, testing, and regulatory approvals, seeing the device in action for the first time felt like the birth of a child, a culmination of hard work and dedication.”
Core Products
What are the company’s core products and features? Dr. Thornes explained:
“Our flagship product is the Pro-X1 Trochanteric Nail, designed to improve outcomes in hip fracture surgeries, and our core technology is an expandable bolt that provides enhanced stability compared to traditional screws or nails. This unique design minimizes complications such as implant cut-out, improves fixation in weak or osteoporotic bone, and supports faster recovery for patients.”
“Our core philosophy revolves around simplicity and reversibility. Orthopedic surgeons prefer straightforward, intuitive tools, and our expandable bolt embodies that. It provides a tactile experience where you can feel, hear, and see the bone anchoring as it expands, creating a stronger, more secure fixation. This sensory feedback is both reassuring and effective for the surgeon.”
Challenges Faced
Have you faced any challenges in your work sector recently? Dr. Thornes acknowledged:
“One persistent challenge is overcoming surgeon perception. Many surgeons believe complications only happen to others, not to themselves. This mindset can make it difficult to convince them to adopt a new device.”
“We’ve tackled this challenge with data. We emphasize that our device is more forgiving, like a golf club or tennis racket with a larger sweet spot. Even the best athletes appreciate equipment that compensates for slight errors, and we frame our product in the same way.”
Evolution Of The Company’s Technology
How has the company integrated technology since launching? Dr. Thornes noted:
“Both our core technology has evolved as well as our integration of technology in different areas of our business. Our device started as stainless steel but transitioned to titanium, which took two years to perfect. This upgrade expanded our capabilities and allowed us to develop a portfolio for use in areas like the spine and humerus.”
“We’ve also embraced virtual reality as a key component of our product lifecycle to enhance customer education. Motivated by seeing Osso VR at industry conferences, we decided to partner with their team to integrate their training modules into our strategy. This approach enables us to deliver cost-effective, cutting-edge training remotely, perfectly aligning with our commitment to simplicity and innovation. Now, we utilize VR modules to train both sales representatives and surgeons, offering immersive, hands-on experiences of our device. With just a VR headset, our team can provide immersive walkthroughs of our device to potential users, and allow them to explore the product anywhere and at any time.”
Significant Milestones
What have been some of the company’s most significant milestones? Dr. Thornes cited:
“One of our most significant milestones was the first case using our device this past September. That moment represented years of development and regulatory work finally coming to fruition.”
“Another major milestone is the robust clinical trial data we’ve generated. Partnering with the University of Oxford, we conducted the largest hip fracture fixation trial ever, involving over 1,000 patients. The results showed our device had the lowest cut-out rate ever recorded in the literature—data we’re now leveraging to drive market adoption.”
Funding
When asking Dr. Thornes about the company’s funding details, he revealed:
“We’ve raised $16 million to date and are currently planning a Series B round for early 2025. While revenue is in its early stages, we’re excited about the traction we’re gaining.”
Differentiation From The Competition
What differentiates the company from its competition? Dr. Thornes affirmed:
“Our product represents a paradigm shift from traditional screws to an expandable bolt. While expandable bolts are common in other industries, they’ve never been properly adapted for orthopedics. We’ve not only done that but also demonstrated its effectiveness in treating osteoporotic fractures, particularly in the hip.”
“Our training approach is also unique. As a small company, we’ve embraced technology to reduce costs and increase accessibility. By working closely with Osso VR on our training programs, we provide surgeons with cutting-edge tools to learn and practice remotely.”
Future Company Goals
What are some of the company’s future goals? Dr. Thornes concluded:
“We aim to expand our product portfolio in the coming year with the introduction of a ‘Petite’ nail, plating solution, and humerus device, as well as licensing our spinal product. With each new launch, we will further integrate VR training, driving technological innovation to the forefront of orthopedic care. Our mission remains focused on advancing patient outcomes and improving quality of life through forward-thinking solutions that set new standards in the industry.”
