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

Some Kaua‘i patients who call the practice already have a joint replacement. It may be a knee that has ached since the day it was done, a hip that has begun to feel loose, or an implant showing signs of infection. Those are the problems Dr. Morton trained for: a University of Chicago fellowship in adult reconstruction that covered complex revision, and an AO Trauma fellowship at Charité in Berlin focused on complex fractures, including breaks around implants. Revision cases sent by other surgeons make up roughly half of his practice.

Other patients come for a first replacement and want the partial-versus-total knee question, or a front-approach hip, explained by the surgeon who will actually operate. Dr. Morton guides the surgical decisions and performs the replacement himself; physician assistants, nurses, therapists and anesthesia providers carry out other steps of your care. His background is on the About Dr. Morton page.

A knee replacement that still hurts. Lasting pain has a cause, and finding it comes before any talk of another operation. Loosening, low-grade infection, instability, scar-tissue stiffness, a poorly positioned component or pain referred from the spine can each be responsible. The revision knee replacement page explains how a failed knee is rebuilt.

An infected replacement. Timing shapes treatment. An early infection can sometimes be cleared while the implant stays in place; a long-standing one usually needs a staged revision. Those plans are made with infectious-disease specialists at Queen’s; the infected knee replacement page explains each treatment.

A first replacement. The choices include a partial or total knee, the quad-sparing subvastus approach, a direct anterior hip, and robotic planning matched to the case and hospital, with ROSA® at Queen’s. How Dr. Morton weighs each is laid out on the joint replacement philosophy page.

Yes. Your first appointment can be a video visit. A text from the office carries a Doximity link, which opens on an iPhone or Android phone at home on Kaua‘i. Imaging is ordered beforehand from a facility close to home, and studies done in Hawai‘i can usually be retrieved electronically, so Dr. Morton has the pictures in front of him during the call.

For a replacement done years ago, the paperwork matters as much as the films. Gather the operative report, the implant card or stickers, and any recent lab results. If you hold older images yourself, upload your images (opens in a new tab) through the practice’s portal; that puts them on file but is not a review and does not schedule a visit. Once the implant is identified and the images are read, much of a revision plan can take shape before you book a seat out of Līhu‘e.

A good deal, and most of it runs through your primary care physician on Kaua‘i, who usually provides medical clearance. Dr. Morton and the anesthesia providers review that clearance along with your medications and any history with anesthesia. If your health means blood work or an EKG is needed, the office tells you which tests and can arrange them; ask whether they can be done on Kaua‘i rather than during the O‘ahu trip.

Your PCP is also the person to work with on an A1c target if you have diabetes. See your dentist before surgery, and plan to hold off on elective dental work for about three months afterward. Quitting smoking or vaping well ahead helps healing; the Hawai‘i Tobacco Quitline is 1-800-QUIT-NOW. Coverage that works through managed care, including HMO and Medicaid/Quest plans, may require a referral from your PCP; the office checks that before your visit. The travel guide’s testing section has more.

One, for most people. Because the video visit, imaging and pre-op groundwork happen on Kaua‘i, the flight from Līhu‘e is for the hands-on exam at the Ala Moana clinic in Honolulu, any final testing, the operation and the early recovery days. An in-person exam always comes before surgery, so it is scheduled into the same trip.

Infection can change the count. A staged revision means two operations separated by a period of antibiotic treatment, so it may require more than one stay on O‘ahu. When that is the plan, or when another complex case needs an extra visit, you hear about it before anything is booked.

North Shore and West Side: the drive to LIH from Hanalei, Princeville, Waimea or Kekaha is a long one, so choose flight times that leave room for the road.

Kaua‘i patients have their surgery on O‘ahu. Together you and Dr. Morton pick between two hospitals, guided by the procedure, your health and what your insurance covers.

• The Queen’s Medical Center, Honolulu: Hawai‘i’s largest hospital and a Level 1 trauma center, where revisions, infected joints and patients with higher medical risk are typically scheduled. ROSA® robotic assistance is available here.
• Adventist Health Castle, Kailua: joint replacement in a hospital setting on O‘ahu’s Windward side, also used for some revisions.

For a first hip or knee, qualified patients can return to their O‘ahu lodging on the day of surgery, and an overnight hospital stay is available when health calls for it. A revision usually means a short inpatient stay. Either way, the days that follow are spent close enough to Ala Moana for follow-up visits.

Kaua‘i patients should plan on about 10–14 days on O‘ahu after a joint replacement. The stay runs through the first post-operative visit, around a week after surgery, and the flight back to Līhu‘e waits for the team’s fit-to-fly clearance. That makes the range a plan, not a guarantee; your own healing sets the date, so buy a return ticket you can move. Smaller procedures often need less time. If yours is a revision, ask the team how the hospital stay fits into the timeline.

Where you stay matters nearly as much as how long. A place near the Ala Moana clinic, minutes from Queen’s, keeps follow-up visits and practice walks simple; the travel guide covers timing in more depth. Booking your own room is normal; you can also ask the Rapid Recovery Concierge, at its Elite Recovery level, to handle flights, lodging and ground transport, though you still pay for the travel itself.

Rehabilitation starts on O‘ahu during the recovery stay and continues on Kaua‘i with a licensed physical therapist you choose. Dr. Morton’s written rehabilitation protocols go directly to that therapist, and the office can suggest names near you if you have no one in mind. Choose someone close to where you live, whether that is Kapa‘a, Kōloa or Waimea, since another person will be driving you for a while.

Follow-up continues from home as well. Telehealth visits on your phone handle wound checks by camera, progress reviews and changes to your therapy, and they are part of routine care. Some questions between visits are handled by Justin Grandalen, PA-C, who works alongside Dr. Morton; you can always ask to see Dr. Morton himself. An X-ray every year for life keeps watch on the implant.

The flight from Honolulu back to Līhu‘e comes once the team clears you, and a few habits make it easier:

• Ask for an aisle seat, and get up to walk whenever it is allowed.
• Sip water through the flight and work your ankles up and down while seated.
• Take your clot-prevention medicine exactly as prescribed, with no extra aspirin or blood thinner for the flight.
• Request wheelchair or cart help through the airport when you book.
• Expect the checkpoint to alarm. No card or letter is needed; tell the officer which joint was replaced, and a wand or pat-down follows. The metal detector article explains why screening cannot harm the implant.

From LIH to Hanalei or Kekaha: you will not be driving yet, so arrange your companion or another driver for the run along Kūhiō or Kaumuali‘i Highway before you leave O‘ahu.