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QuikBow®: The Next Generation K-Bow

To further streamline skeletal traction, Arbutus Medical recently launched the QuikBow® pin tensioner. This is a simplified version of the conventional Kirschner Bow (K-bow) device, otherwise known as the common traction bow, used by orthopaedic surgeons to apply skeletal traction for the temporary stabilization of the femoral shaft, acetabular (hip), pelvis and other types of fractures.

John Kodosky – an orthopaedic trauma physician assistant at UT Health San Antonio, associate professor, and expert in skeletal traction pin placement  – was one of the spearheads behind the idea of the QuikBow®. He strongly believed that the equipment available for the skeletal traction procedure needed to be updated and made more user friendly. 

“Within thirty minutes of meeting the Arbutus team many years ago, I said to them that if you really want to make something, make a new bow – because the current bows function very poorly, they don’t work, they break, they’re hard to find and they just cause a significant amount of consternation whenever we’re trying to locate them and use them” he said.

One of the most common complaints of using the conventional K-bow is its inefficiency.  After use, K-Bows frequently end up in different parts of the hospital, and then the busy hospital staff must remember to return each K-Bow to the Central Sterile Processing Department (SPDs). This doesn’t always happen. So, K-Bows are frequently lost and unavailable when needed, which leads to a lot of waiting for the patient, surgeon, and staff in the ER. Ultimately, these delays impact both patient care and hospital costs.

What’s more, the conventional K-Bow requires two people for it to work – one to hold the wire-grippers in place, and another to turn the handle. But two people aren’t always available in a busy ER or ICU, leading to more delays. The QuikBow® comes as a solution to many of these problems. 

“The Arbutus QuikBow® only requires a single person – it has springs on it which you pull down and it latches onto the pin and when you let go it holds it in place, and then you do one and a quarter turns, and there’s your tension,” Kodosky explained. “That’s it. I mean it. It’s just easy.” QuikBow® is also the market’s first single-use K-bow, making it readily available for staff.

QuikBow®  is another example of Arbutus Medical’s principles of “Frugal Innovation” at work, an innovation philosophy that the company believes is well-positioned to address the next 100 years of challenges facing healthcare systems across the world.

Like Arbutus Medical’s flagship DrillCover Technology platform, QuikBow® represents a solution to a neglected problem – a real unmet need. Arbutus Medical’s process for identifying real unmet needs is central to the company’s principles of Frugal Innovation. The company leverages a concept which co-Founder Michael Cancilla calls “systematized listening”, and pairs it with fast action and reaction to customer feedback. The key to systematized listening is to ensure that Arbutus’ development team listens to how customers and partners speak about problems and needs in their own words

Fast development cycles play a critical role in solving unmet needs. An agile team and short time-to-market means that Arbutus Medical is able to improve patient care in areas that might have been deemed a non-viable market by the rest of the industry. From the time of idea conception, it took one year to launch the QuikBow®. The design team worked tirelessly to ensure that it perfectly suited the needs of patients and medical practitioners, without compromising on its functionality and the end result. The first six months were spent working through numerous design iterations while capturing user feedback from prototypes. The next couple of months were dedicated to refining the design to make it sleeker and manufacturable, and the last four months to manufacture and build the moulds which mass produce these. 

And, critically, QuikBow® – paired with Arbutus Medical’s TrakPak® skeletal traction procedure kit – delivers economic value to hospitals. By standardizing skeletal traction, and eliminating steps in the procedural and equipment gathering workflows, hospitals win back key resources in their ERs, ICUs, and SPDs.

“The story of the QuikBow® is really all about listening, and just making something that fits the users’ needs,” said Radu Postole, the lead product designer at Arbutus Medical. “We had over 50 iterations of prototypes during the development process. We would 3D print one iteration, ship it to a user the next day, then integrate the feedback into another prototype 2 days later. .”

The team worked closely with a skeletal traction design group – including Kodosky – to get an expert’s viewpoint on the usability of the QuikBow®. Kodosky said his two main conditions were “single person, and single use”.

The design team was able to eliminate the second person required, but “single-use” posed a dilemma to Arbutus Medical. With waste and environmental sustainability being a major 21st century healthcare challenge, the company was hesitant to solve one problem while exacerbating another, and challenged the design team to do better than status-quo. 

In the end, the material picked for the QuikBow® represents an innovation in itself. Arbutus Medical partnered with Arkema Group to manufacture QuikBow® using the Rilsan® FKZM 65 O TD MED, a plant-based plastic (> 98%) that allows companies to replace metal and traditional polymers without compromising on performance.

In plain terms, this means that QuikBow® is largely made from castor beans – a sustainable, renewable crop that does not compete with food and does not cause deforestation. Castor beans are actually seeds which when planted, give rise to more seeds. Arkema sources its castor beans from Gujarat, in India, where it is a part of the Pragati initiative to train farmers and equip them with the skills to sustainably cultivate castor beans. Also, as a part of its objective to be more eco-friendly, Arkema has launched the Virtucycle service, dedicated to recycling specialty polyamides and PVDF fluoropolymers. Arbutus hopes this material selection will generate a positive environmental and social impact, and pave the way for more high-performance devices like QuikBow® to be made from plant-based materials.

“For the amount of performance we needed in this device, it had to be very strong, very stiff, and also bio compatible.,” Radu explained. “What was really intriguing for us was that it was bio based, and sustainably sourced too, based on all the literature that they’re providing us with on the farming initiatives they’re doing in India. And they have a recycling program, so that’s what pushed us in that direction versus other material options that we had.”

Arbutus Medical is committed to minimizing the environmental footprint of QuikBow®. The team commissioned a cradle-to-grave Life Cycle Analysis to better understand how the product generates emissions, and to identify strategies to minimize footprint. The company is also piloting an environmental impact-reduction program (known as BlueWave) where it will test the viability of recycling, refurbishing and carbon offset programs with its early customers. 

Although it’s only been a few months since its launch, the QuikBow® has already been used in over 300 procedures across at least 11 facilities. Kodosky believes that by introducing tools like the QuikBow®, Arbutus Medical is not only making the treatment experience better for the patient, but also for the medical community. “They’re not just trying to solve a problem, they’re trying to make patient care and provider care better. And the skeletal traction system is just the beginning for Arbutus and what they will be doing in the future.”