Hip & Knee Replacement for Patients from West Hawai‘i

With a clinic already in Kailua-Kona, the travel here is mostly about surgery day, and about the surgeon who makes it worthwhile. Dr. Morton’s link to this coast is on record: on March 3, 2022, he performed the first robotic joint replacement on Hawai‘i Island at Kona Community Hospital. That is history rather than current practice, since his robotic replacements on the island are now done in Hilo. A Kea‘au native and University of Hawai‘i medical graduate, he came home to Hawai‘i to practice after adult-reconstruction fellowship training in Chicago. The surgical judgment and the operation are his; a physician assistant, nurses, therapists and anesthesia staff share the rest of the pathway. More on the About Dr. Morton page.

Every plan begins with an exam and standing X-rays in Kona. From there, the main paths are:

• Partial or total knee. When only one part of the knee is worn and the ACL is sound, a partial may do; once arthritis has spread across the joint, a total is the better answer, nearly always with the subvastus technique that spares the quadriceps. Compare the two.
• Direct anterior hip. Dr. Morton’s standard. If old hardware, earlier hip surgery or significant deformity tilts the balance toward a different approach, you will hear that from him directly.
• Mako robotic planning. A CT scan of your joint becomes a 3D model; he performs each step while the robot gives live feedback on alignment and balance. See how robotic planning works.
• Revision. Loose, worn, unstable or infected replacements, including ones done elsewhere, start with a full workup before any decision.

Yes. From the far ends of the region, such as Ocean View in Ka‘ū or Hāwī in North Kohala, it is worth settling before the first drive into town. Tell the office where your scans were taken. In-state imaging normally comes over electronically, and stale films can be replaced with new X-rays at a Kona-area facility. Imaging from outside the state can be sent ahead: upload your images (opens in a new tab) through the practice portal so it is ready for your visit. Sending files does not count as a review or an appointment. For a replaced joint that hurts, add the operative report and implant card. A first conversation can also be a telehealth visit while you are in Hawai‘i, joined on your phone through a Doximity link sent by text. Before any surgery, Dr. Morton examines you in person, usually at the Kona clinic.

Nearly everything, and the visits stay in Kona. The pre-operative appointment happens at the Kona clinic. Medical clearance normally comes from your own primary care provider. If labs or an EKG are needed, the office specifies them and can book them, and you can ask about a location near home. The CT scan that the Mako plan is built from also comes before surgery day. Use the lead time for health work, such as bringing diabetes toward the A1c goal you and your doctor agree on, giving up tobacco or vaping early, and seeing your dentist. Shortly before the operation, your coordinator confirms when to arrive in Hilo, where to park and how to check in. The travel guide covers health preparation in more depth.

For a routine replacement, the one big trip is a drive, not a flight: surgery day in Hilo. Your consultation, pre-operative visit and follow-ups, beginning about a week after surgery, are at the Kona clinic, and telehealth covers the days between clinic sessions. If you live toward North Kohala or Ka‘ū, ask which of those visits can be done by video to spare you the drive into town, and ask where your CT scan will be done. When a case needs an O‘ahu hospital, such as an infected joint or a revision with significant bone loss, the exam, last tests, operation and first recovery days are grouped into a single planned stay, and any extra visit a complex case needs is known before you buy a ticket. Some Hawai‘i health plans help with interisland airfare and lodging for medically necessary off-island care, and the office can check yours. The trip-planning guide has more.

Dr. Morton does not perform joint replacements in Kona today. For most West Hawai‘i patients, a first-time Mako hip, knee or partial knee replacement happens at Hilo Community Surgery Center, on the other side of the island. Everyone there goes home the same day, so it is meant for patients whose health is stable and who have a driver and helper staying with them for at least the first 24 to 72 hours. When there is reason for hospital-level care, such as an infected joint, a complex revision or reconstruction, or a medical history that could warrant overnight observation in a hospital, the operation is planned from the beginning at an O‘ahu hospital, typically The Queen’s Medical Center. Infection decisions there are made with infectious-disease specialists. Procedure, health and insurance decide your venue, and you hear the reasoning at your Kona visit.

It depends on where the operation is done. After surgery in Hilo you are discharged the same day, and home might be Captain Cook, Hōlualoa or Hāwī, a long ride at the end of an operating day. Before the operation, raise the idea of a night in Hilo with the team; they may recommend it, and the booking is yours. Wherever you sleep, your companion is with you through at least the first 24 to 72 hours. Follow-up then returns to Kona, starting around a week after surgery. An O‘ahu operation means budgeting about 10–14 days in Honolulu, enough to get past the first post-operative check and the team’s fit-to-fly sign-off; it is a planning range, not a guarantee. The travel guide’s section on how long to stay explains the reasoning.

Therapy picks up a day or two after you get home, in the house or at a clinic, and Hilo is not part of it. You choose a licensed physical therapist convenient to you anywhere in West Hawai‘i. The office can suggest therapists and sends Dr. Morton’s rehab protocols to yours, so the exercises match the plan for your joint. Plan on a walker early on and a cane after a couple of weeks, depending on balance. Between Kona visits, telehealth check-ins let the team see your incision, hear how therapy is going and adjust it, as part of routine care. Keep an eye on the incision as you work: tell the office promptly about fever, new redness or drainage, or pain that comes back after it had settled, because an infection caught early can sometimes be treated while keeping the implant. Longer term, a yearly X-ray keeps watch on the implant.

This applies only when your operation is in Honolulu. Treat the return flight to Kona as a date you can move: follow-up and fit-to-fly clearance are planned in advance, and you board once cleared, never on the day of surgery. Ask the airline for wheelchair or cart assistance at booking, and have someone meet you at the Kona airport, since driving waits until you are off narcotic pain medicine and cleared to drive. In the air, an aisle seat makes it easier to stand and walk; drink water and work your ankles while seated. Keep to the clot-prevention medicine you were prescribed, with no extra doses because you are flying. At the checkpoint your implant will probably set off the metal detector; a word to the officer is enough, with no card or letter, and screening does it no harm. Once you are home, follow-up picks up again at the Kona clinic. See airport security with a joint replacement.