Foxpat is an entirely reusable surgical trainer developed in collaboration with Zimmer Biomet, Inc.

Foxpat provides a safe and realistic environment for training partial knee replacement technique. Surgeons can practice multiple times before they try on a real patient. Foxpat is also intelligent enough to give feedback to the surgeons on their performance.

Cementless Oxford Partial Knee replacement has been one of the most successful knee reconstructions by Zimmer Biomet. Besides being sophisticated in its design, it requires careful implantation techniques to be followed. The existing digital trainers do not help training such techniques.

Foxpat was developed to train the surgeons on Cementless Knee replacement surgery. Cementless knee replacement requires more attention than a cemented knee replacement technique.

Research

It takes about 25 surgeries for new surgeons to be proficient at knee replacements.

Qidong et al., Journal of Orthopaedic Surgery and Research, 9:81

As of today, this process is more complex. Surgeons learn small steps by observing from experienced surgeons. Then they try on one step at a time on the patient and eventually does one full surgery by themselves after 90 surgeries. There is a strong evidence that the survival rate of knee implantation is lower for novice surgeons than experienced surgeons.

The Oxford Instructional Course takes place thrice a year brings the novice surgeons together to teach the surgical techniques and patient selection criteria. Although the course was well designed to provide useful information, it lacks a well built surgical trainer for novice surgeons to experience the surgical procedure.

Teaching is just not enough to be competent. Continuous coaching is necessary to be great at something.

Novice surgeons are always taught the surgical procedure. But they need to perfect the surgical technique. Perfection is a matter of difference between 99.5 % and 99.95%. This is acquired with ‘fallibility’- a tendency to make mistakes. That is why experienced surgeons have better outcomes than the novice surgeons. It is not necessarily that they make mistakes, but they learn from previous procedures and try to improve. For a novice surgeon to have a short learning curve, they need to make more mistakes which is only possible within the training.

Perfection, it comes with the tendency to make mistakes.

Atul Gawande – Harvard Graduate School Forum, 2012

Design process

Concept training model

To develop a fully functional manufacturable design, it was essential to know the practical requirements of the product usability. Although synthesis gave an idea of the desired qualities of the product, the functional requirements were not precise yet. During this design phase, a quick mock-up was developed with basic requirements. The plan was to demonstrate this prototype in an upcoming Oxford training course to get detailed feedback.

Testing the concept in Oxford

Design

With Foxpat, surgeons can now practice multiple times before they operate on a real patient.

The aim was to provide a safe and realistic training platform where surgeons are allowed to make mistakes without harming a patient and gain the essential surgical skills.