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

A good share of Honolulu patients arrive with the plan already written: a total knee, a new hip, or a revision of an implant someone else placed. A second opinion here exists to test that plan, not to replace your surgeon by default. Dr. Morton studies the images on screen himself instead of leaning on the radiology report, reads the operative and clinic notes, examines you, and then puts his impression and the options he sees in writing, typically within one to two weeks.

Send or bring the actual X-rays, MRI or CT files rather than summaries; the office can usually retrieve anything scanned in Hawai‘i electronically. Plenty of patients carry the written impression home, return to the surgeon who first advised them and have the operation there, and that is a perfectly good result. Because you live in town, the in-person exam that has to happen before any surgery is easy to arrange. A checklist of what to gather sits on the second opinion page.

On nearly every total knee, Dr. Morton uses the subvastus approach, slipping under the inner quadriceps muscle instead of dividing the quadriceps tendon. No tourniquet is used on any first-time knee. A very muscular or tight knee, a large deformity, or scarring from earlier surgery can call for a different exposure. The implant is set to your own leg alignment and ligament balance, held inside published safe-zone limits, through an incision of about 4–6 inches, and fixation is cementless or cemented depending on bone quality seen on X-ray and confirmed during the operation.

If home is up a sloping Liliha street or a Pālolo house with steps at the front door, raise stairs at the first visit. Thigh strength is what lifts you from one step to the next after surgery, and a prehab program starts building it beforehand. The knee replacement hub explains each choice.

Dr. Morton’s usual hip operation is the direct anterior approach. The muscles around the hip stay attached and intact while he works through the joint capsule alone, and for most people that means no hip precautions once they are home. If the hip you are bringing for a second look has been operated on before, still holds hardware from an earlier repair, is badly deformed, lies beneath a heavy overhanging fold of skin, or has healed poorly in the past, he will tell you plainly when a different approach is the safer one. A hip being revised may simply go back through the earlier scar.

If this will be your first anterior hip, ask whether a bikini-line incision fits; it is offered when your anatomy allows. Implants are usually a titanium cup holding a cross-linked polyethylene liner, matched in most cases with a ceramic head, and fixed without cement where the bone is good enough. Leg length is checked with X-rays during the operation. The philosophy page explains why he works this way.

Whether a partial would do instead of a total is a fair question for a second look in town. A partial resurfaces a single worn compartment and keeps the ACL. It suits a knee whose arthritis stays in that one compartment, whose ACL is intact, which still straightens well, whose deformity is mild and correctable, and whose pain has not answered to therapy, medication and injections. Wear spread across two or three compartments, an ACL that is torn or missing, rheumatoid or another inflammatory arthritis, or severe deformity all point toward a total.

Medial, lateral, patellofemoral and bicompartmental partials are all part of Dr. Morton’s practice, so whichever pattern your X-rays show, the matching operation is available. The honest trade-off is a somewhat higher chance of revision over a lifetime with a partial. Age is not the deciding factor; the exam and X-rays taken while you stand are. The partial vs total comparison lays out both sides.

If you are comparing two recommendations, it is fair to ask each surgeon what the robot actually does. With Dr. Morton, it carries out the 3D plan he made before surgery and reports alignment and balance while he works. At no point does it cut by itself or make a choice; each step of the operation is his. In 2022 he performed Hawai‘i’s first robotic-assisted total hip replacement, using ROSA®.

Which platform is used on O‘ahu depends on your operation and the hospital. At Queen’s, he uses ROSA, and because ROSA plans from standard X-rays, there is no extra CT appointment. His certifications cover four systems: ROSA, Mako, CORI and VELYS. On essentially every hip, the robot helps set leg length, offset, stem size and the angle of the cup, and spine X-rays taken both standing and sitting can personalize that angle. Robotics cannot guarantee equal leg lengths, which is why X-rays are also taken in the operating room. Robotic assistance carries no separate patient fee. More on ROSA and the robotic hip.

Roughly half the cases in Dr. Morton’s practice are revisions sent by other surgeons, and his Revision Hip & Knee Clinic routinely evaluates implants put in on the mainland, overseas and here in the islands. If you live in town with a hip or knee that has never felt right, finding the cause comes before any talk of surgery. That means new X-rays laid beside your older ones, blood work for ESR and CRP, fluid drawn from the joint and cultured if infection is on the list, metal-artifact-reduction imaging by MRI or CT when questions remain, and pinning down the implant’s model, size and recall status.

What turns up is usually one of a familiar set: a loose or infected implant, an unstable joint, worn plastic with bone loss behind it, a break in the bone around the implant, a reaction to metal debris, scar-tissue stiffness, or a component sitting in the wrong position. Each leads to a different fix, and some painful joints turn out not to need surgery at all. When a revision is warranted, it is usually planned at Queen’s with a short inpatient stay.

From anywhere in town, the trip is a city drive. The Honolulu clinic is opposite Ala Moana Center, parking is in the building’s own structure, and the streets around it are flat. Clinic hours are Monday–Friday, 8:00 am – 4:30 pm HST, and new patients are usually seen within one to two weeks; book with the Schedule button or call (808) 439-6201. If the West O‘ahu clinic in Kunia fits your week better, consultations, imaging and follow-ups can be done there.

Surgery in town is done at The Queen’s Medical Center, a few minutes from the clinic. Some later check-ins can be video visits on Doximity: the office sends a link by text, and you tap in from an iPhone or Android phone while you are in Hawai‘i. You are always examined in person before surgery. If a relative is flying in from a neighbor island to help, the travel guide explains what a support person does.

Valley and ridge neighborhoods such as Nu‘uanu, Pālolo and Liliha mean hills outside and, often, stairs at home, and that shapes the plan for leaving the hospital. Going home the same day requires a plan for every step into and inside the house, a support person for at least the first night, and health that is well controlled. You leave once you are walking safely, eating and drinking, and managing pain with pills, not when a set number of hours has passed. When your health calls for it, an overnight stay at Queen’s is available.

Most people take their first steps with a walker on surgery day; after about the first couple of weeks, they trade it for a cane once balance allows. Physical therapy begins a day or two after you get home, either with the in-house therapists at Ala Moana or with any licensed therapist close to you, using Dr. Morton’s written rehab protocols. The first check is around one week after surgery, and a yearly X-ray keeps watch on the implant for life.