Hip & Knee Replacement for Patients in ‘Ewa Beach, Hawai‘i

A replaced knee that still aches long after it should have quieted down is one of the clearest reasons for a second look. There is usually a cause, and it is worth finding before you either accept the pain or agree to another operation. A recommendation you feel unsure about, for a first replacement or a redo, is the other. ‘Ewa Beach patients can be seen for this at Kunia. Dr. Morton re-reads the scans and X-rays personally, examines you, and puts his view and your choices in writing, typically within one to two weeks. An MRI is usually not needed to begin.

Outside films can go into the practice’s portal ahead of time, so you can upload your images (opens in a new tab) from home. The portal only holds them; it is not a review and books nothing. Redness, warmth, swelling or drainage around a replaced joint, or a fever, is a reason to call (808) 439-6201 promptly; the when to call page lists more. The second opinion page describes the full process.

Sleeping at home in Ocean Pointe or ‘Ewa Gentry the night after a new knee depends partly on technique. In nearly all of his total knees Dr. Morton works under the quadriceps rather than through its tendon, the subvastus or quad-sparing route, and no tourniquet is used on a first-time knee. Anesthesia providers add nerve blocks to an opioid-sparing pain plan. Together these help make same-day discharge realistic for qualified patients. Knees that are unusually stiff, muscular, deformed or scarred, and most revisions, may need a different exposure.

Implant placement follows the way your own leg is aligned and your ligaments are balanced, inside published limits, and the long-term record of this personalized method is still growing. Bone strength decides fixation: cementless when it is sound, cement when it is soft, and your consent covers both. The knee replacement page and the alignment section of the philosophy page go deeper.

A hip replacement can be a same-day operation as well. Dr. Morton’s standard is the direct anterior approach through the front of the hip, where the joint capsule is opened and the muscles stay attached to bone. Most patients leave without hip precautions, which makes settling into the car for the drive back down Fort Weaver Road less fiddly. When the hip’s history or shape, such as a prior operation, old hardware or a marked deformity, makes another approach safer, he uses it and tells you why.

Ask about a bikini-line incision; it is offered when anatomy allows and lengthened if more room is needed. Robotic planning on essentially every hip covers the socket angle, stem size, leg length and offset, and an X-ray checks leg length during surgery. Even so, robotics cannot guarantee equal legs, as the page on leg length after hip replacement explains. A titanium shell, a cross-linked polyethylene liner and usually a ceramic ball are the common combination, with dual mobility held back for hips at greater risk of dislocating.

Sometimes only one part of a knee is worn out. Standing X-rays, which Kunia can take on the day of your visit, plus Dr. Morton’s exam generally show whether a partial is possible; an MRI is added only for a specific open question. A partial resurfaces that single compartment and leaves the ACL doing its job. It suits arthritis confined to one area, a sound ACL, a knee that still straightens well, little deformity, and pain that therapy, medicines and injections have not calmed.

Wear in several compartments, a torn or missing ACL, inflammatory arthritis such as rheumatoid, or a severe deformity favor a total instead. Medial, lateral, patellofemoral and bicompartmental partials are all done robotically from a 3D plan, through a smaller incision and without a tourniquet. The honest trade-off is a somewhat higher lifetime chance of revision, and converting a partial to a total, though generally simpler than redoing a failed total, still counts as one. Age is not the deciding factor. Read about partial knee replacement.

Think of the robot as a precise measuring and guiding tool in Dr. Morton’s hands. He draws up a 3D plan for your joint before surgery. During the operation the system tracks his work against that plan and displays alignment and ligament balance, but it never cuts by itself and decides nothing. On O‘ahu the platform is chosen to suit your case and hospital; at Queen’s it is ROSA®, planned from regular X-rays with no CT scan.

If you are on Medicare, robotic assistance does not alter what is covered. It is billed the same as a standard joint replacement, with no technology fee or extra charge to you. Dr. Morton holds certifications on ROSA, Mako, CORI and VELYS, and in 2022 he performed the first robotic-assisted total hip replacement in Hawai‘i. His patients’ nickname for him is “The Robot Doc.” See ROSA robotic joint replacement for how the planning works.

When infection is behind a painful replacement, the calendar shapes the treatment. Found soon after it starts, an infection can sometimes be handled without removing the implant: the joint is washed out, the plastic liner swapped and antibiotics given (DAIR). A chronic infection more often needs two operations, first removing the implant and placing a spacer, then rebuilding once the infection is cleared; selected patients can have a single-stage exchange instead. Dr. Morton plans these with infectious-disease specialists, using hospital resources at Queen’s.

Most painful replacements are not infected, and nothing is revised without a diagnosis. The Revision Hip & Knee Clinic moves through old-versus-new X-rays, inflammation blood tests, joint aspiration, specialized MRI or CT, and a check of the implant’s identity and recall history. Missing bone can be rebuilt with augments, cones, sleeves and longer stems, and an unstable joint with different bearings or added constraint. Revisions are hospital operations, mostly at Queen’s, usually with a short inpatient stay.

Kunia is the nearby clinic from ‘Ewa Beach. It is in the Kunia Shopping Center, where parking is free, close to H-1 and H-2, and it handles first visits, imaging, injections, pre-operative appointments and check-ups. For some visits and for questions between them you may see Justin Grandalen, PA-C, who works alongside Dr. Morton; you can always ask for Dr. Morton. A sprain on the course or a fall at home can go to Wiki Wiki Orthopedics, the practice’s walk-in orthopedic urgent care in the same center, with X-ray on site; phone to confirm its hours that day.

The operating venue is a shared decision weighing procedure, health and insurance: Queen’s for complex work, revisions and higher-risk patients, and Castle in Kailua as the other choice. Medicare, TRICARE and VA Community Care are accepted, and the veterans and TRICARE page covers referral steps. HMO and managed-care plans may need a referral, which the office looks into. Call (808) 439-6201 or book online; new patients are usually seen in one to two weeks.

The level streets of the ‘Ewa Plain are an easy place to rebuild your walking. Expect a walker on surgery day and for about the first couple of weeks, then a cane once your balance is steady. Therapy starts on the first or second day home, in the house or at a clinic. You can use the in-house therapists at Kunia or any licensed therapist near ‘Ewa Gentry, Ocean Pointe or Hoakalei, and the office will pass along Dr. Morton’s written protocols.

Protect the incision as instructed; wound care explains dressings and showering. Wound checks can be done by phone camera over Doximity video, and your first follow-up is around a week after surgery. Aspirin for several weeks is the usual clot prevention, taken exactly as prescribed. Golf returns in stages: the short game around six weeks, then full rounds about three months after a hip and three to six months after a knee, riding in a cart at first. The golf guide has more tips.