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

Advice that leaves a nagging question is worth testing. For a Kailua hip, the question might be whether a front approach was considered, and whether the operation could be done at Castle and finished the same day. For others, a replaced hip has slipped out of its socket more than once, or a knee has stayed hot and swollen long after surgery, and they want the cause found first.

Expect Dr. Morton to pull up the X-rays, MRI or CT and read them himself, go over the notes from earlier visits and surgery, and examine the joint. Typically within one to two weeks, his impression and the options he sees are on paper, and you may carry that back to your own surgeon. The portal lets you upload your images (opens in a new tab) before the visit, which simply keeps them on hand; it neither counts as a review nor books an appointment. What to gather is on the second opinion page.

Dr. Morton reaches nearly every total knee through the subvastus approach, passing beneath the quadriceps instead of dividing its tendon. That muscle does the work of carrying you across the sand at Kailua Beach, so leaving it intact is the point. He may choose another route for a heavily muscled or tight knee, a marked deformity, or a knee scarred by past surgery. Tourniquets are never used on a first-time knee.

Through a 4–6 inch incision, the implant is positioned to match how your leg is naturally aligned and how your ligaments balance, without straying outside published safe-zone limits. Whether it is cemented comes down to bone quality, judged on X-ray and confirmed in surgery: good bone takes a cementless implant, softer bone a cemented one, and you agree to either beforehand. Today’s knee implants commonly last 20 years or more. The knee replacement overview and the subvastus page explain each choice.

Dr. Morton replaces hips from the front as a rule. Through the direct anterior approach he opens the joint capsule and nothing else, leaving muscle on bone, and most patients leave without a list of hip precautions. Earlier operations on the same hip, leftover hardware, a badly deformed joint, a heavy fold of skin hanging over the front, or a history of slow wound healing can make another approach safer, and he will tell you if yours is that case.

This close to Kailua Beach and Lanikai, the bikini-line incision, hidden where swimwear covers it, is a natural question. It is offered when your anatomy allows; if more room is needed, he extends to a standard anterior incision rather than compromise the implant’s position. The typical hip pairs a titanium shell and a cross-linked polyethylene liner with a ceramic ball, set without cement where bone allows, and dual mobility is held back for hips more likely to dislocate. More on direct anterior hip replacement.

A partial knee swaps out just the worn compartment and leaves the ACL in place. The knee that suits one has its wear limited to a single compartment, a working ACL, the ability to straighten well and no more than a mild, correctable deformity, and still hurts despite therapy, medicines and injections. Wear that has spread, a torn or missing ACL, an inflammatory arthritis such as rheumatoid, or a large deformity favors a total instead.

Medial, lateral, patellofemoral and bicompartmental versions are all in Dr. Morton’s practice; each is planned in 3D and placed robotically through a shorter incision, without a tourniquet. The trade-off: a somewhat higher lifetime chance of another operation, and switching a partial to a total, though usually simpler than redoing a failed total, is still a revision. Age alone is not the test; an exam and X-rays taken standing are, and both can happen at the Ala Moana consultation, so one drive over the Pali can answer the question. His reasoning is on the philosophy page.

When a robot is part of your operation, its role is narrow. It follows the 3D plan Dr. Morton prepares ahead of time and reports alignment and balance to him live. The robot does not cut by itself or choose anything; he does every step. Which system you get on O‘ahu depends on the operation and the hospital. At Queen’s it is ROSA®, planned from regular X-rays with no CT required.

His certifications span ROSA, Mako, CORI and VELYS, and the first robotic-assisted total hip replacement in Hawai‘i, in 2022, was his (more about him). For hips, the plan covers where the cup sits, the size of the stem, and leg length and offset, though X-rays in the operating room still double-check length, because no robot guarantees equal legs. You pay no separate fee for the robot. Read about robotic hip replacement.

If you live in Kailua with a replaced hip that has dislocated, a knee that gives way, or a joint you suspect is infected, nobody should operate until the cause is proven. At Dr. Morton’s Revision Hip & Knee Clinic, that proof is built step by step: today’s X-rays read against older ones, ESR and CRP blood tests, a joint aspiration sent for culture if infection is on the table, MRI or CT with metal-artifact reduction if doubt remains, and a check of exactly which implant you carry, its size and any recall.

Other findings include loosening, plastic wear that has eaten into bone, a break next to the implant, a metal-debris reaction, stiffness or a malpositioned component. Where bone is missing, porous augments, cones or sleeves and longer revision stems rebuild it. A revision is a hospital operation, at Queen’s in most cases and at Castle in some, and usually means a short admission. The revision hip page covers the surgery itself.

Consultations are on the far side of the mountains. Head over the Pali Highway or through H-3 to the Ala Moana clinic, where you can park in the building, or to Kunia if that suits your day. Pack photo ID and your insurance card, plus a medication list and whatever imaging you already have. Plenty of later check-ins skip the drive: the office texts a Doximity link, and you tap it on your iPhone or Android phone to join.

Surgery may not require the crossing. You and Dr. Morton pick the hospital together, weighing the operation, your health and your insurance. Castle, nearest for Kailua, Kāne‘ohe and Waimānalo alike, can take a first-time hip or knee that fits your case and coverage, whereas revisions, complex reconstructions and patients with higher medical risk are usually booked at The Queen’s Medical Center. The office line, (808) 439-6201, is answered weekdays from 8:00 am to 4:30 pm, and new patients are mostly seen within one to two weeks.

With surgery at Castle, the ride home stays on the Windward side and family can visit without crossing the Pali. You will most likely be on your feet with a walker that same day, keep it for roughly the first couple of weeks, and trade it for a cane once your balance is steady. Driving waits for Dr. Morton’s clearance, on average two to six weeks, and only after you are done with narcotic pain pills and can stamp on the brake; until then, someone else takes you to town.

Your first check comes around a week after surgery. After that, incision checks by camera and progress reviews can happen over video from your living room. For clot prevention, most people take aspirin for several weeks, exactly as prescribed. Once the first year is behind you, a yearly X-ray keeps an eye on the implant for good. Details are in the knee recovery guide and in the first year after hip replacement.