Hip & Knee Replacement for Patients in ‘Aiea, Hawai‘i

You may arrive with pictures already taken: X-rays ordered by a primary care doctor, an MRI from after a fall, or films of a joint replaced long ago. What you want is a surgeon who studies those images directly instead of skimming a one-paragraph report. Dr. Morton does. He re-reads the films and scans, works through any operative notes and implant records, examines you, and gives you a written impression with the options he sees, typically within one to two weeks.

Bring or send the actual images rather than the radiologist’s summary. Studies from Hawai‘i facilities can usually be pulled electronically, and if you hold the files yourself you can upload your images (opens in a new tab) so they are on hand; that step is not a review and does not book anything. There is no pressure to change surgeons, and many people take the written impression back to their own. The second opinion page lists what helps most.

When arthritis has worn through the whole knee, Dr. Morton’s total knee follows a steady method. On nearly every patient he enters through the subvastus approach, passing under the quadriceps so its tendon is left uncut; very muscular or tight knees, marked deformity, old surgical scarring and most revisions are the exceptions. He never uses a tourniquet on a primary knee, and the incision is usually 4–6 inches.

The implant is set to your own leg alignment and ligament balance, within published safe-zone limits, an approach whose long-term data is still building. Cementless parts are used when X-rays and the operating room both show good bone; cemented parts, with the longest track record, suit weaker bone, and you consent to either. If home is on one of the streets climbing toward ‘Aiea Heights, mention the steps into your house at the first visit, since they shape the plan for your first days back. See the robotic knee replacement page and the subvastus section of the philosophy page.

For hips, Dr. Morton’s standard is the direct anterior approach. Only the joint capsule is opened; no muscle is cut or detached from bone, so most patients have no hip precautions to follow. Small daily moves, like easing into the car after a Pearlridge errand, stay simpler in the early weeks. When an earlier operation on that hip, leftover hardware, significant deformity, a large overhanging skin fold or past wound-healing trouble makes another approach safer, he tells you, and a revision may reuse the old scar.

Robotic guidance is part of essentially every hip he performs. The plan covers cup angle, stem size, leg length and offset, and X-rays of your spine standing and sitting can personalize where the cup points. He checks leg length with X-rays during surgery, though no robot can promise perfectly equal legs. A bikini-line incision is an option if your anatomy allows. See robotic hip replacement.

Some knees wear out in one area only, and a partial knee resurfaces that one compartment and keeps your ACL. You may be a candidate when the damage stays in one compartment, the ACL is sound, the knee straightens fully or close to it, any bowing or knock-knee is mild and correctable, and therapy, medicines and injections no longer hold the pain down. Two or three worn compartments, a torn or missing ACL, rheumatoid or another inflammatory arthritis, or severe deformity means a total is the better fit.

Dr. Morton does medial, lateral, patellofemoral and bicompartmental partials, all planned in 3D and performed robotically through a smaller incision with no tourniquet. The trade-off: over a lifetime, partials need revision somewhat more often, and turning one into a total, though usually easier than redoing a failed total, still counts as a revision. Age is not the deciding factor; an exam and standing X-rays at Kunia or Ala Moana are. The partial vs total section explains how he decides.

What is the robot really for? Think of it in two parts. Before surgery, Dr. Morton designs a 3D plan for your joint. During surgery, the robot keeps his instruments true to that plan and shows live alignment and ligament-balance numbers. It never cuts by itself, never chooses anything, and never stands in for the surgeon; he performs every step. Using it adds no technology fee or separate charge, because it is billed as standard joint replacement, and your Medicare coverage stays the same.

Which system is used is matched to the case and the venue. At Queen’s, that system is ROSA®, which plans from ordinary X-rays and so needs no CT scan. Dr. Morton holds certification on ROSA, Mako, CORI and VELYS and performed Hawai‘i’s first robotic-assisted total hip replacement in 2022; patients call him “The Robot Doc.” More on ROSA and on his training.

With an older replacement, two complaints deserve a careful look: a joint that seems to have come loose, and one that feels unstable, buckling in a knee or dislocating in a hip. Neither is treated by guesswork. His Revision Hip & Knee Clinic lines up new X-rays beside older ones, checks ESR and CRP in the blood, draws and cultures joint fluid when infection is a possibility, adds metal-artifact-reduction MRI or CT if questions remain, and identifies the exact implant and its recall status. Nothing is revised until the cause is known.

The repair then follows that cause. Lost bone is rebuilt with porous augments, cones or sleeves and revision stems; instability is treated with implant and bearing choices, for example dual mobility in a hip or more constraint in a knee. Revisions are planned at a hospital, most at The Queen’s Medical Center, usually with a short inpatient stay. See revision hip replacement.

Because ‘Aiea lies between the practice’s two O‘ahu clinics, you can pick by schedule rather than habit. Westbound, the Kunia clinic is in the Kunia Shopping Center, with free parking and quick H-1/H-2 access, and handles consultations, injections, imaging and follow-ups. Eastbound, the Ala Moana clinic sits across from Ala Moana Center, with parking in the building and Queen’s minutes away. If your day already runs toward town, Ala Moana may be easier; if it runs west, Kunia. Either clinic can take fresh standing X-rays during your appointment.

Some visits and between-visit questions are handled with Justin Grandalen, PA-C, who works with Dr. Morton; you can always ask to see Dr. Morton himself. Where you have surgery is decided with you, by procedure, health and insurance, and complex or revision cases are usually booked at Queen’s. Call (808) 439-6201 or tap Schedule. Neighbors in Pearl City and Mililani use the Kunia clinic as well.

Most patients walk with a walker on surgery day, lean on it for about the first couple of weeks, and switch to a cane once balance is steady. Therapy begins on the first or second day home, either at your house or in a clinic, with any licensed therapist convenient to ‘Aiea; the office can name a few and sends them Dr. Morton’s written protocols. The first follow-up is around one week out, and later wound checks can be done by Doximity video, joined from the link the office texts to your iPhone or Android phone.

Clot prevention for most patients is aspirin for several weeks, about a month after a knee; take it exactly as prescribed. The ‘Aiea Loop Trail has to wait a bit longer than neighborhood walks: trails usually come back around three months, with steep, technical or long hikes later in the first year. See hiking after knee replacement and the travel guide’s physical therapy notes.