The title comes from the Dorothy Parker poem: Inventory.
As much as I proclaim myself to be sort of blase about the series loss, I find myself unable to fall asleep. And since Mike Lowell goes under the knife later today, let's talk surgery.
Arthroscopic surgery can be performed under local anaesthesia as an out-patient procedure. But not Mikey's. Given the complicated structural nature of the hip with it's deep musculature, and the involvement of the vascular and nervous systems, it's better to perform the surgery under general anaesthesia when you can more easily regulate those functions; i.e. paralyze him, lower his blood pressure, and slow his heart rate so he doesn't gush blood all over the place. And to control the gross-out factor. One must never underestimate the gross-out factor.
The first step of the procedure is to yank his femur out of his socket (which is not only extremely painful and will leave him with a very impressive bruise afterward, it's also decidedly horrible-looking during the surgery.) The joint is separated so that the surgeon has room to work. He then makes two or three tiny (a centimeter or two long) slits through the tissue. Through one of these slits, he'll insert an arthroscope (similar to a straw, it's a hollow rod with a light and a camera attached to it.) He'll use the other slits to insert his other instruments.
Once he's in, the first step will be to debride (clean out) the joint. While cartilage is a fabulous substance (essentially it's strands of the protein collagen woven around water), it does have it's faults. It's main issue: it doesn't have a blood supply. When it gets damaged it takes a long time for it to fix itself. Inside Mike's acetabulum there will likely be pieces of broken-off cartilage floating around and the labrum will probably be shredded. Once the surgeon has scraped out the damaged cartilage, he'll throw a couple of stitches into what remains of the healthy labrum.
The next issue to be dealt with would be the impingement. I'm not certain that this problem was made clear before (so he might not have an impingement) but since Mike was talking about bone spurs with 'EEI, it's probably a safe assumption to make. An impingement is caused by an osteophyte (literally: bone growth) but not by a bone spur, as such. Essentially, the bone of Mike's femoral head has a bump on it. The bump limits his range of motion and bangs into his labrum. They'll deal with that issue by shaving off the growth. And if there aren't any other problems, close him up and wake him up.
I was rummaging recently and I came across this video:
It's from the Southern California Orthopedic Institute (I found it here-they actually have a much clearer description of what's going on in Mike's hip than I was able to muster) and it's the first in a series of videos of an actual hip arthroscopy.
Seriously: Don't click the video if you don't really want to know. It's an actual surgery and isn't pretty. It might, in fact, be described as gruesome. The surgeon asked "Hey! Can I record your procedure and then throw it up on YouTube?" and his patient replied "Go for it." Fair warning.
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