Hip & Knee Replacement for Patients in Downtown Honolulu, Hawai‘i

Some downtown patients already have a surgery date and a lingering doubt about it. Others have a replacement that hurts and have been told the fix is another operation, perhaps in two stages because of infection. These are weighty choices to make around a working schedule, and checking them with a second surgeon is routine in orthopedics. Dr. Morton re-reads your scans and X-rays personally, goes through the operative notes and any lab results, examines you, and writes up his view of the diagnosis and your options, typically within one to two weeks.

That written impression belongs to you. Many people take it back to the surgeon who first advised them and proceed there; nobody will press you to change. If the real question is whether a loose or infected implant truly needs revising, the second opinion service is set up for exactly that, beginning with a proper workup before anyone talks about operating dates.

For a first total knee, Dr. Morton’s routine pairs a quad-sparing subvastus exposure with no tourniquet. He sets the components to suit the way your own leg is aligned and how your ligaments balance, staying inside published safe-zone limits. Fixation is chosen from your X-rays and confirmed in the operating room: cementless where the bone is strong, cemented where it is weaker. Cemented fixation has the longest track record, and you consent to both before surgery. Knee implants commonly last 20 years or more.

When you plan a new knee, plan around your job too. Sitting at a desk comes back well before kneeling on a hard floor, lifting heavy loads, or climbing ladders and stairs, and those heavier duties are cleared individually rather than by a stock date. Describe a normal workday at your consultation so the recovery plan reflects it. Each technique is explained on the knee replacement page and in the fixation section of the philosophy page.

Hips are replaced through the direct anterior approach as Dr. Morton’s standard. The joint capsule is opened without cutting or detaching muscle from bone, and most patients have no hip precautions afterward. That keeps ordinary office life simpler: sitting in a desk chair, rising from it, getting into a car or onto a bus. Sometimes a different approach is the safer one: a hip operated on before, metal hardware left from an earlier repair, marked deformity, a big overhanging fold of skin, or a past wound that was slow to heal. He tells you when that applies.

Planning covers cup position, stem size, leg length and offset, and standing and sitting spine X-rays can tailor the cup target to you. The standard pairing is a titanium shell with a cross-linked polyethylene insert, usually with a ceramic ball; dual-mobility bearings are saved for people more likely to dislocate. Implant choice is never about brand preference. The anterior hip page goes into more detail.

When only one compartment of the knee is worn, a partial replacement may be enough. It keeps the ACL and the healthy cartilage, goes through a smaller incision without a tourniquet, and is planned in 3D and performed with robotic help. Partial knee patients also tend to recover faster, which is worth raising if time away from work weighs on you. The usual profile: wear in just one compartment, a sound ACL, a knee that still straightens properly, a mild deformity that can be corrected, and pain that therapy, medication and injections have failed to quiet.

A total is the better choice when wear has spread to two or three compartments, the ACL is torn or missing, the arthritis is inflammatory, or the deformity is severe. Over a lifetime, partials are revised somewhat more often; turning one into a total is generally simpler than revising a failed total but still counts as a revision. See partial knee replacement for the full picture.

ROSA® is the robotic system Dr. Morton uses at Queen’s, so robotic-assisted hip and knee replacement is available at the hospital in your neighborhood. A complex case does not have to give up robotic planning because it needs a full hospital behind it. ROSA plans from plain X-rays, so you skip a CT scan, and in the operating room it tracks the bones, positions cutting guides at the planned angles and reports alignment and ligament balance as the case proceeds.

On O‘ahu the platform is matched to the case and the venue, and he is certified on four of them: ROSA, Mako, CORI and VELYS. Billing treats a robotic case as an ordinary joint replacement: there is no technology fee, and Medicare coverage stays the same. The robot measures and guides; the surgeon operates. The ROSA page walks through a case step by step, and the robotic planning section explains how each plan is built.

Queen’s is where Dr. Morton typically schedules revision hip and knee surgery, so for people who live or work downtown, the hospital handling a complex case is close at hand. It is Hawai‘i’s largest hospital and a Level 1 trauma center, and it holds Advanced Certification for total hip and total knee replacement from The Joint Commission. A revision usually involves a short inpatient stay.

None of that begins until the cause is known. Loosening, infection, recurrent dislocation, wear with bone loss, a fracture around the implant, a reaction to metal debris, stiffness and a badly positioned component each call for a different repair. The diagnostic steps compare new X-rays with old ones, check inflammation markers in the blood, sample joint fluid for culture when infection is suspected, and identify the implant down to its model, size and recall status. The Revision Hip & Knee Clinic runs that workup; the operations themselves are described on the revision knee and revision hip pages.

Two places matter for a downtown patient. Appointments are at the Ala Moana clinic, which faces Ala Moana Center, a short trip from the business district or the Capitol area, with parking in the building. Surgery can be at Queen’s on Punchbowl Street, in the same part of town where you may already work; the venue is chosen with you. Depending on your health, pre-operative blood work and an EKG may be needed; the office tells you which tests apply and can schedule them, so ask whether they can be done close to your home or office.

The clinic is open Monday–Friday, 8:00 am – 4:30 pm HST, and new patients usually get in within one to two weeks. Book with the Schedule button on this site or call (808) 439-6201. A short follow-up can sometimes be a Doximity video visit: the office texts a link to your iPhone or Android phone, and you need to be in Hawai‘i to join. Before any operation, you are examined in person.

Most people are on their feet with a walker on the day of surgery and keep it for about the first couple of weeks before moving to a cane. An anesthesiologist places nerve blocks, and the pain plan is opioid-sparing, so many patients need opioids for just a few days. Most take aspirin for several weeks to lower the risk of clots, while higher-risk patients may be prescribed a blood thinner; follow whichever plan you are given exactly.

Therapy starts on the first or second day home. The in-house therapists at the Ala Moana clinic work from Dr. Morton’s written protocols, and if a therapist near your home or workplace suits you better, any licensed physical therapist can follow the same protocols, which the office sends directly. The first post-operative visit is around one week after surgery. Once you are back at work, ask your therapist how to break up long stretches of sitting or standing. Clot prevention and rehab protocols have their own pages.