Hip & Knee Replacement for Patients from Kea‘au, Hawai‘i

From Kea‘au, traveling for a new hip or knee usually means the drive into Hilo, not an interisland flight. A routine joint replacement on Hawai‘i Island used to mean flying to O‘ahu. Now that Dr. Morton performs Mako robotic surgery at Hilo Community Surgery Center, most routine operations for people from Kea‘au, Hawaiian Paradise Park or Kurtistown stay on the island, and the plan is to sleep in your own bed that night.

The reason to make even that short trip is the training behind the operation. Dr. Morton is board-certified by the American Board of Orthopaedic Surgery, completed a fellowship in adult reconstruction at the University of Chicago, and is certified on four robotic platforms. O‘ahu is held back for the cases that genuinely need a hospital, such as complex revisions or a health picture that calls for a night of monitoring. The Hawai‘i Island part of the travel guide compares the two paths.

The choices that shape a recovery are all available in Hilo, so picking one does not add a flight. If arthritis has worn only one compartment of the knee, the ACL is intact and the knee still straightens well, a partial knee replacement may suit you better than a total; standing X-rays and an exam decide it, and age alone does not. For a total knee, Dr. Morton uses the subvastus approach on nearly every patient, working under the quadriceps muscle so its tendon is left uncut, and he never uses a tourniquet on a first-time knee.

Hips are replaced from the front as his standard. The direct anterior approach opens only the joint capsule, and a bikini-line incision is possible when your anatomy allows. Each Mako hip and knee is planned in 3D from a CT scan of your own joint. The philosophy page explains how each choice is made.

Yes, and it keeps the first appointment from being spent waiting on paperwork. X-rays and MRI scans done in Hawai‘i can usually be retrieved electronically, so when you call, tell the office where yours were taken. If you have copies at home, you can upload your images (opens in a new tab) to the practice’s portal. That simply puts them on hand for the team; it is not a review in itself and it does not book a visit.

Dr. Morton reads the images himself at your appointment, and with the Hilo clinic this close, starting there in person is usually simplest. You probably will not need an MRI first: an exam and weight-bearing X-rays come before anything else, and an MRI is ordered only when a specific question remains. If your joint was already replaced elsewhere, look for the operative report or implant card so the exact model can be identified.

Nearly all the preparation happens in the weeks before. For a Mako operation you will have a CT scan of the joint, with no IV contrast, and that scan becomes the 3D model on which your implant sizes and positions are planned. Medical clearance usually comes from your own primary care provider, while Dr. Morton and the anesthesia team review your heart, lungs, medicines and history with anesthesia. Depending on your health, that may mean blood work or an EKG; the office tells you which tests you need and can schedule them.

Spend the waiting time getting ready. See your dentist, agree on an A1c target with your doctor if you have diabetes, and quit smoking or vaping well ahead. The prehab guide shows exercises worth starting now. Then settle the logistics: if you live deep in Hawaiian Paradise Park or Orchidland, line up who will drive you to Puuhonu Place on surgery day, home again, and back for your first follow-up.

When surgery is in Hilo, you count drives rather than flights. Each one lines up with a step of care: the consultation at the Hilo clinic, a pre-operative visit and the CT scan for your Mako plan, surgery day, and follow-up visits beginning around one week afterward. On days the clinic is not running, some check-ins can be done by telehealth: the office texts you a Doximity link, and you join on an iPhone or Android phone.

If yours is one of the cases planned on O‘ahu, the shape changes. Consultation and follow-up still take place in Hilo, and the O‘ahu trip bundles the in-person exam, the remaining tests, the operation and early recovery into one stay. Now and then a complex case needs one more visit, and you would know that before booking anything. The trip-planning section of the travel guide details the O‘ahu version.

Most first-time hip, knee and partial knee replacements for Kea‘au patients take place at Hilo Community Surgery Center on Puuhonu Place. It is a same-day center with no overnight stay, so you go home once you are walking safely, eating and drinking, and comfortable on pain pills. Dr. Morton performs the operation himself; the Mako arm holds the bone work to his plan, gives him feedback on alignment and balance, and never cuts on its own. He leads the surgical decisions, while his physician assistant, the nurses, the anesthesia providers who place your nerve blocks and your therapists carry other parts of your care.

If your health may need a night of monitoring, or the job is a complex revision, surgery is planned at a hospital from the outset, typically The Queen’s Medical Center in Honolulu. The procedure, your health and your insurance set the venue, and the reasons are discussed with you.

After surgery in Hilo, there is no staying away: the plan is to go home to Kea‘au the same day. What needs planning is who stays with you. A companion should be in the house for at least the first 24 to 72 hours, nights as well, keeping medicines on schedule, helping with ice and elevation, and walking with you. Your first follow-up visit at the Hilo clinic comes around one week after surgery.

If your operation is planned on O‘ahu, expect to remain near the surgical facility for about 10–14 days, through your first post-operative check, and fly only after the surgical team clears you. Treat that as a planning range and book flights you can change. Most traveling patients choose a hotel or condo near the Honolulu clinic with elevator access and room for a companion; the practice is not affiliated with any property. The Elite Recovery level of the Rapid Recovery Concierge can arrange the travel, though flights and lodging remain your own expense.

Therapy starts on the first or second day after you get home, either with a therapist who visits the house or at an outpatient clinic. You can use any licensed physical therapist convenient to Kea‘au or Hilo. The office can suggest some near you, and it sends Dr. Morton’s written rehabilitation protocols straight to the therapist you choose, so each stage has clear goals.

Plan the rides as carefully as the exercises. Most people use a walker for about the first couple of weeks, then a cane as their balance allows. Driving waits until you are off narcotic pain medicine and can brake hard without hesitating, on average two to six weeks. From a house in Hawaiian Acres or Kurtistown, that means someone else at the wheel for each therapy session for a while. Telehealth check-ins let the team follow your progress and adjust therapy between clinic visits.

Many patients from Kea‘au will not need this part, but if a revision or a higher-risk case takes you to Queen’s, the flight back to Hilo waits until the surgical team clears you to fly, and it is never on the day of surgery. Ask the airline for wheelchair or cart assistance when you book. On board, take an aisle seat, get up and walk when you can, drink water, and do ankle pumps in your seat. Stay on the clot-prevention plan you were prescribed and do not add aspirin or a blood thinner because of the flight; the clot prevention page explains the plan.

The walk-through metal detector will likely pick up your implant. No card or letter is needed; tell the officer which joint was replaced, and know that airport screening cannot harm it. After you land, follow-up returns to the Hilo clinic, with telehealth check-ins in between.