Hip & Knee Replacement for Patients from Waikoloa, Hawai‘i

Waikoloa has no Pacific Bone & Joint office, so an in-person visit means heading south on Route 19 to Kailua-Kona. The reason to make that drive is the surgeon behind the Kona clinic door. Dr. Morton’s hip and knee fellowship was at the University of Chicago, and a second, AO Trauma fellowship at Charité in Berlin covered complex fractures, including breaks around implants. Other orthopedic surgeons refer him revision cases, roughly half of his practice, and his Revision Hip & Knee Clinic sees implants from the mainland and overseas as a matter of course. That is worth knowing if your first operation happened far from Hawai‘i. He leads the surgical decisions and carries out the operation in person; a physician assistant, nurses, therapists and anesthesia providers handle much of what surrounds it.

For a hip, the starting point is the direct anterior approach, which opens only the joint capsule rather than cutting or detaching muscle, and generally leaves you without hip precautions. Hoping to hide the scar under a swimsuit? A bikini-line incision is possible when your anatomy allows; should the operation need more exposure, he extends the cut instead of settling for a less accurate implant position. For a knee, standing X-rays and an exam settle partial versus total: one worn compartment with an intact ACL can point to a partial, while wider wear calls for a total, typically through the subvastus approach. On Hawai‘i Island every one of these is mapped on Mako from your CT scan, including cup position, leg length and offset for hips. If the trouble is an existing replacement, that is a revision question, answered further down.

Yes, and gathering them early pays off. The office requests records for you, and studies from Hawai‘i imaging centers usually arrive electronically. If your hip or knee was replaced on the mainland or overseas, collect what you can before the first appointment: the operative report, the implant card or stickers, and the X-ray images themselves rather than only the radiologist’s summary. With those, Dr. Morton can identify the model and size of your components and check whether any of them has been recalled. If you want a formal second opinion, Dr. Morton reads the films himself and you receive his impression and options in writing, usually inside one to two weeks. Gaps in the paperwork are common, and components can often be identified from X-rays alone. More on second opinions.

Most of the preparation runs through the Kona clinic and your own doctor. Kona hosts the pre-operative visit; your primary care provider normally signs the medical clearance. Lab work or an EKG, if your health calls for them, are listed and arranged by the office, which can check whether somewhere closer to Waikoloa will do. A CT scan of the joint, taken without IV contrast, is the foundation of the Mako plan. Two other jobs are worth starting early. First, choose the physical therapist you will use afterward and consider a few sessions of prehab with them, so the first visit after surgery is not a first meeting. Second, get a dental checkup, because elective dental work then waits about three months after surgery. The team gives written instructions on blood thinners and supplements, and your companion should be lined up for surgery day and the days after it.

Think of it as several short trips and one long one. The short ones run south to the Kona clinic for the consultation, the pre-operative visit and follow-up care, starting roughly a week after surgery. Telehealth can stand in for some of those drives while you are in Hawai‘i. The long one is surgery day: across the island to Hilo with your companion, then home the same day or after a night near Hilo. Ask where your CT scan will be done when it is ordered. If your operation is better suited to an O‘ahu hospital, such as revising a mainland implant with bone loss, it becomes one planned trip combining the in-person exam, final tests, the operation and the first stage of recovery. Complex cases occasionally need an extra visit, and you will know before anything is booked. The Hawai‘i Island section of the travel guide has the full picture.

Dr. Morton’s Hawai‘i Island operations take place in Hilo, not in Kona. Most Waikoloa patients needing a first-time hip, knee or partial knee replacement are operated on at Hilo Community Surgery Center with the Mako robot, working from the plan built on your CT scan. Because it is a same-day center, it fits people in generally good health whose medical conditions are under control, with a companion who can drive and remain with them for a minimum of the first 24 to 72 hours. When there is a reason for hospital resources, such as a loose or failed implant, substantial bone loss, or health that may need a night of observation, the operation is scheduled at a hospital from the outset, usually The Queen’s Medical Center in Honolulu, Hawai‘i’s largest hospital. Revisions there generally come with a short inpatient stay. Your procedure, health and insurance determine the setting, and you hear the reasoning first.

For surgery in Hilo, not long at all. You leave the center the same day, once you are walking safely with a walker, eating and drinking, and comfortable on pills; discharge follows those milestones rather than the clock. What needs planning is the return to Waikoloa, which can mean crossing the island on the day of your operation. Talk with the team beforehand about whether to spend that first night near Hilo and drive home rested the next day. Whichever you choose, your companion is there through those first days, helping with medicines, meals and walks. From then on, care moves to the Kona clinic, with the first follow-up around a week after surgery, so the Hilo drive is usually a one-time trip. If your operation is on O‘ahu, the timeline is longer; the question below about staying in Honolulu covers it, and the travel guide goes deeper.

Therapy happens near Waikoloa, not in Hilo. It begins within the first couple of days after you get home, at your house or at a clinic, with a licensed physical therapist of your choosing. The office can recommend names and shares Dr. Morton’s written protocols with your therapist directly, so the exercises follow his plan. Between Kona visits, video check-ins let the team look at the incision and adjust therapy. On the Kohala Coast the water is a natural question. A new knee keeps you on dry land until the wound has fully healed and you have the all-clear, usually at the six-week mark. A new hip can usually get into a pool sooner, often about a month out once the incision is sealed and cleared, while open-ocean swimming, snorkeling and paddling wait until roughly three months. The first-year hip timeline has more.

This matters only if a revision or complex case is done in Honolulu. The return flight to the Kona airport waits for the surgical team’s fit-to-fly clearance and is never on the day of surgery. Because the airport lies south of Waikoloa along the same highway, arrange a driver for the last leg home; you may not be cleared to drive yet. Request wheelchair or cart assistance when you book. During the flight, sit on the aisle, get up and walk when it is safe, keep drinking water and pump your ankles. Follow your prescribed clot-prevention plan exactly, with no extra aspirin or blood thinner for the trip. At security the implant will most likely set off the walk-through detector; tell the officer which joint was replaced. No card or letter is required, and screening cannot damage it. More on clot prevention and flying home.