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

A surgical trip off Lāna‘i means a flight, a planned O‘ahu stay and a willing companion, so be clear about what it is for. Some come for a first replacement, wanting the type, approach and fixation chosen for their own joint rather than a single default. Others come because an earlier replacement, done on another island, the mainland or abroad, has turned painful or unstable and no one has explained why.

A board-certified orthopedic surgeon, Dr. Morton is a Fellow of the American Association of Hip and Knee Surgeons. After medical school at the University of Hawai‘i, he completed fellowships in adult reconstruction (University of Chicago) and AO Trauma (Charité, Berlin), the second focused on complex fractures and breaks around implants. Revision surgery referred by colleagues makes up about half of what he does. The About Dr. Morton page has the full background.

These choices are usually talked through by video before you leave Lāna‘i, then checked at the in-person exam.

Knee. A partial knee is considered when arthritis sits in one compartment and the ACL is sound. Every type is in his repertoire: medial (inner), lateral (outer), patellofemoral (behind the kneecap) and bicompartmental. He explains how he weighs partial against total. A total knee is set to match how your own leg is aligned and how its ligaments balance, kept inside published safe-zone limits, with cementless fixation when the bone is strong enough.

Hip. Hips are usually done from the front, through the direct anterior approach; earlier surgery, hardware or deformity can make another route safer. When anatomy allows, the incision can sit along the bikini line, and X-rays taken in the operating room help check leg length.

Robotics. On O‘ahu the robot depends on your case and hospital; ROSA®, used at Queen’s, plans from ordinary X-rays without a CT scan. It follows Dr. Morton’s plan, and he does the surgery.

A replacement you already have. Nothing is redone until a workup explains the problem.

For Lāna‘i patients, that review is the first appointment, held as a video visit. At the appointed time you join through the Doximity link the office has texted to your phone, an iPhone or Android, and Dr. Morton takes your history, watches you walk and move, and studies your imaging with you.

Where possible, the office orders X-rays close to home. If a study you need can’t be done close by, settle with the office where and when it happens; it may make sense to time it with your O‘ahu trip. Scans already taken in Hawai‘i are usually fetched electronically. Copies from elsewhere can go through the portal: upload your images (opens in a new tab) and they will be waiting. Uploading isn’t a review, and no appointment comes from it.

Asking about a replacement done elsewhere? An operative report or implant card helps pin down the exact components; without them, the implant can usually be identified from records and X-rays.

Much of the medical preparation can be finished without leaving Lāna‘i. Your primary care provider usually gives the medical clearance. The anesthesia team and Dr. Morton then add their own review of your heart and lungs, your medicines and how anesthesia has gone for you before. Whether you need blood work or an EKG depends on your health. The office names the tests and can schedule them, and it is worth asking whether your own doctor can arrange them closer to home. The final round of pre-operative testing happens on the surgical trip.

Use the weeks beforehand well. See your dentist, because non-urgent dental work should be put off for about three months after the operation. Stop smoking or vaping. With diabetes, work toward the A1c target you set with your doctor. The travel guide covers each step, and prehab helps you get ready for the first days.

In most cases, one. With the consultation done by video and preparation handled on Lāna‘i, the surgical trip is often the only one, and it runs in a set order. First comes your in-person examination, which always precedes an operation; most fly-in patients book lodging near the Honolulu clinic. Then final pre-operative testing, the operation, a first check after surgery and, at the end, clearance to fly. The interisland travel page shows a typical itinerary.

A few situations call for more. A complex revision may need a separate visit beforehand, and an infected replacement treated in two stages means two operations, months apart. If either applies, you hear it while the plan is taking shape, before any flight is booked. Because the return depends on clearance, pick fares you can change.

Your operation will be at one of two O‘ahu hospitals. On the Windward side, Adventist Health Castle in Kailua is a hospital where Dr. Morton performs hip and knee replacement. In Honolulu, minutes from the Ala Moana clinic, The Queen’s Medical Center is Hawai‘i’s largest hospital; it usually takes revisions, complex reconstructions and patients whose health carries more risk. The Joint Commission has granted Queen’s Advanced Certification for both total hip and total knee replacement.

You and Dr. Morton pick the hospital together, weighing the procedure, your health and your coverage. Some patients qualify to return to their lodging on the day of surgery; others stay the night when their health makes that safer. A revision means a hospital plan from the outset and normally a short admission. Surgical judgment and the operation itself are Dr. Morton’s; physician assistant Justin Grandalen, nursing staff, anesthesia providers and therapists may share other parts of your care.

Your O‘ahu stay after a hip or knee replacement should be planned at about 10–14 days. It includes the first check after surgery, at roughly one week, and finishes with the surgical team’s go-ahead for the flight to LNY. That range is for planning, not a guarantee; the team’s clearance sets the real date, and smaller procedures often need fewer days. Follow-up visits and the fit-to-fly appointment are set before you leave Lāna‘i.

You can book lodging and flights yourself, or the Rapid Recovery Concierge can handle those bookings at its Elite Recovery level, with the travel costs still yours. For a hotel stay compared with other places to recover, see extended stay after surgery. Ask about your plan’s interisland travel benefit too: certain Hawai‘i health plans assist with interisland flights or lodging when off-island treatment is medically necessary, and the office can find out whether yours does.

Your first therapy sessions usually take place before you fly, near the clinic on O‘ahu (the Honolulu clinic has in-house physical therapists), so you head home already knowing the exercises. After that, any licensed physical therapist you choose can continue your program. Before surgery, put three questions to the office:

1. Which therapists can it suggest for someone living in Lāna‘i City?
2. How will Dr. Morton’s written rehabilitation protocols get to the therapist you choose?
3. How will video check-ins fit around your therapy, so the team can see the incision and adjust the plan?

Most people trade the walker for a cane once the first couple of weeks have passed and their balance allows.

Your flight back to Lāna‘i waits for the surgical team’s clearance and is never booked for the day of surgery. It is generally on a small commuter plane, so arrange wheelchair or cart assistance with the airline when you book, and let your companion manage the luggage.

The in-flight habits are about blood flow. Move when you can, sip water, and pump your feet at the ankle in your seat. Follow the clot-prevention plan on your discharge sheet to the letter, and don’t add aspirin or another blood thinner because you are flying; see the blood clot prevention guide.

If your departure includes a security checkpoint, the new joint will likely trip the metal detector. TSA asks for no implant card or letter: tell the officer, for example, that your left knee was replaced, and expect a wand or quick pat-down, which does the implant no harm. Arrange the short drive from LNY to Lāna‘i City before you leave O‘ahu.