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300,000 patients suffer a hip fracture annually in the US, with an economic burden of $12Bn. A single hip fracture episode costs $40,000 to the healthcare payor. The incidence and economic burden is expected to rise by 50% by 2025. With traditional screw fixation, reoperations occur in 6% of patients, at 120% the cost of the index case (i.e. an additional $50,000 for a reoperation case). A typical hospital fixing 250 hip fractures will spend an addtional $750,000 annually in reoperation costs, equating to a $3,000 premium per patient episode and notwithstanding the massive functional and emotional impact on these typically elderly frail patients.

Hip fixation failure and reoperation is most often due to 'cut-out' with poor bone quality and thus poor anchorage in the femoral head. Modelling the idea/concept of wall fixation expanding bolts, the X-Bolt gives strong anchorage with rotational stability, minimum bone disruption, and avoids spinning the femoral head. It is also easily reversible and removable, if need be.  X-Bolt Orthopaedics was established in 2007, with CE Mark and first clinical cases in 2011.

Clinical studies include the WHITE One (n=100) and WHITE Four (n=964) randomized control trials, XHS vs SHS, with a 0% X-BOLT reoperation rate in the published WHITE One study.




1. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Mineral Research 2007; 22:465–475

2. Svedbom A, Hernlund E, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Abrahamsen B, Kanis JA. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporosis 2013; 8:137:1-218

3. Thakar C, Alsousou J, Hamilton TW, Willett K. The cost and consequences of proximal femoral fractures which require further surgery following initial fixation. Bone & Joint Journal. 2010; 92:1669-77

4. Palmer SJ, Parker MJ, Hollingworth W. The cost and implications of reoperation after surgery for fracture of the hip. Bone & Joint Journal. 2000; 82:864-6

5. Foss NB, Palm H, Krasheninnikoff M, Kehlet H, Gebuhr P. Impact of surgical complications on length of stay after hip fracture surgery. Injury. 2007; 38:780-4


X-Bolt. The Hip Fracture Fixation Company
(UK) +44 1172 300632   (Ire) +353 1 8527103   Email. info@x-bolt.com 
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