title: Consideration of religious sentiments while selecting a biological product for knee arthroscopy.
abstract: OBJECTIVE
  There is an increasing use of various synthetic and biological products in orthopaedics. The use of a biological product can be a major area of concern for patients of various cultures/religions. The purpose of this work is to study various restrictions in different faiths and their compatibility with available products focused on cartilage repair.
  
  
  METHODS
  A systematic search in several databases, CINAHL, EMBASE, Global health, PubMed, MEDLINE and the Cochrane collaboration, was performed to find out various religious beliefs of some major religions regarding the use of animal products. Hindu, Muslim, Christian, Jewish and Buddhist faiths were studied to find out whether animal-derived surgical implants are permitted. Major religious scholars were asked about their opinions, and guidelines related to human/religious ethics were evaluated. A market survey was carried out to find out biological contents of various products and their compatibility.
  
  
  RESULTS
  Jews and Muslims have religious restrictions for porcine products, while Hindus reject bovine products. Vegetarian Hindus reject usage of any animal product. Most Christians do not have any restrictions except those who follow vegetarian dietary regulations. Though there is no prohibition for the use of animal products in Buddhism, a code of non-violence to animals is being followed. However, difference of opinion exists about interpretation of these dietary guidelines for surgical usage amongst various scholars.
  
  
  CONCLUSIONS
  Products of biological origin have a definite restriction for various religions, with few exceptions. Surgeons should know the source of the product and should be aware of the basic requirements of the patient's faith. Patient should be informed about the source of the product and alternative if available, and an informed consent may be considered.
  
  
  METHODS
  Type of study, Level V.
authors.affiliation: Saumya Orthocare, Centre for Advanced Surgeries of the Knee Joint, Sabarmati, Ahmedabad 380005, India. deepak@knee.in
authors.forename: Deepak
authors.initials: D
authors.lastname: Goyal
authors.forename: Anjali
authors.initials: A
authors.lastname: Goyal
authors.forename: Mats
authors.initials: M
authors.lastname: Brittberg
mesh_terms: D000818:Animals; D001688:Biological Products; D002016:Buddhism; D002835:Christianity; D018596:Hinduism; D006801:Humans; D007514:Islam; D007599:Judaism; D009985:Orthopedics; D012068:Religion and Medicine
chemical_list: D001688:Biological Products