Hip & Knee Replacement for Patients in Kaka‘ako, Hawai‘i

One question a second opinion can settle is whether a knee booked for a total could have been a partial, or whether a partial that was offered is really enough. Another is why a knee or hip that has already been replaced still aches. Either one deserves an answer built from the images, not from a one-line report summary. Dr. Morton looks at the X-ray, MRI or CT files himself, examines you, and sends a written impression covering the diagnosis as he sees it and the choices open to you, typically within one to two weeks.

Gather the images, the operative report if you have had surgery, and the recommendation you were given; studies done in Hawai‘i can usually be retrieved electronically. With the Ala Moana clinic next door, the in-person exam is simple to fit in. Many patients carry the impression back to their own surgeon, with no expectation that they switch. The second opinion page has a checklist.

Knee replacement is a family of operations rather than one. Depending on where the cartilage has worn, Dr. Morton may suggest a medial, lateral, patellofemoral or bicompartmental partial, or a total knee. For a total, he uses the subvastus approach on nearly every knee, lifting the quadriceps rather than cutting its tendon, and no tourniquet on any primary knee. Implant position follows your natural alignment and ligament tension, kept within the published safe zone. A total’s incision runs about 4–6 inches; a partial’s is smaller.

Bone that is strong enough takes a cementless implant, as read from the X-rays and checked again in surgery; weaker bone gets cement. Whichever knee you end up with, the rehab that follows can happen in the therapy gym at the Ala Moana clinic, close to Ward and Kewalo, with therapists working from the same plan as the surgeon. The alignment notes explain how implant position is chosen.

Dr. Morton replaces hips through the direct anterior approach as a rule, opening the joint capsule rather than cutting or detaching muscle, so most patients skip the familiar list of hip precautions. If you would like a scar that hides under swimwear, ask about a bikini-line incision; for a first anterior hip it is available when your anatomy allows. If the operation calls for more room, he lengthens the incision into a standard anterior one; the implant’s position always takes priority over the scar.

A typical hip combines a titanium socket shell, a cross-linked plastic lining and, in most cases, a ceramic ball, fixed without cement when bone quality allows; dual mobility is kept for those at higher dislocation risk. Previous surgery on that hip, hardware still in the bone, a significant deformity, a large skin fold or trouble with wound healing can make another approach the safer one, and he will say so. The implant selection notes explain the choices.

If you are weighing a partial knee, it helps to know what it keeps. Only the worn compartment is resurfaced; the ACL, the PCL and the healthy cartilage stay where they are. Dr. Morton plans each partial in 3D and performs it with robotic assistance, using a shorter incision and no tourniquet, and partial patients tend to recover faster. For someone hoping to be back on the waterfront paths soon, that is a genuine advantage when the knee qualifies.

The trade-off is durability: across a lifetime, a partial is somewhat more likely than a total to need revising. Wear in more than one compartment, an inflammatory arthritis or a damaged ACL steers the choice toward a total, and age does not decide the matter by itself. The FAQ below covers candidacy in more detail, and the partial vs total comparison sets out both operations side by side so you can bring specific questions to your visit.

Robotic assistance is part of how Dr. Morton plans and performs partial knees as well as total knees and hips. He builds a 3D plan before surgery, and during the operation the robot executes it while giving him live readings of alignment and balance. It never makes a cut by itself or chooses anything; every step is his. The same approach applies whether the knee is getting a partial or a total.

Four platforms carry his certification, ROSA®, Mako, CORI and VELYS, and on O‘ahu the one used is chosen to fit the case and the hospital. At Queen’s, in neighboring downtown Honolulu, he uses ROSA, which needs only ordinary X-rays for planning, not a CT scan. For hips, robotic guidance sets cup position, stem size, leg length and offset, and X-rays taken during surgery double-check leg length, since no robot can guarantee it. Read more about the robotic knee.

A partial knee can fail in ways of its own: arthritis can advance in a compartment that was healthy at the first operation, or a component can come loose. Converting a failed partial to a total tends to be less involved than reworking a failed total, though it is still a revision and gets the same planning. Partials, totals and hips can also fail from other causes: infection, a joint that slips or dislocates, wear that leads to bone loss, a fracture beside the implant, a reaction to metal debris, scarring that stiffens the joint, or parts set in the wrong position.

Other surgeons refer revision cases to Dr. Morton, including implants first placed on the mainland or overseas, and he does not revise without a diagnosis. Revision surgery takes place in a hospital, typically Queen’s, and you should expect a short inpatient stay. The revision clinic handles the workup, and the partial knee pain guide covers why partials are revised.

From Kaka‘ako, Ward or Kewalo, the Ala Moana clinic is next door, facing Ala Moana Center, with parking inside the building for days when walking over is not practical. Your consultation, X-rays taken standing, pre-op visits, follow-ups and therapy sessions all happen there, and new patients generally get an appointment within one to two weeks. Surgery can be scheduled at The Queen’s Medical Center on Punchbowl Street in neighboring downtown Honolulu; the venue is chosen with you.

Some follow-ups can be done by video without leaving your apartment. The office texts you a Doximity link and you open it on an iPhone or Android phone; these calls are only for patients physically in Hawai‘i, and nobody goes into surgery without an in-person exam first. To book, use the Schedule button or call (808) 439-6201 Monday–Friday, 8:00 am – 4:30 pm HST.

An elevator building takes the stairs out of the equation, and stairs are one of the things a same-day discharge plan has to solve. The rest still applies: an adult staying with you at least the first night, health conditions under control, and the willingness to get up and walk early. You head home once you are walking safely, taking food and fluids, and comfortable on oral pain pills.

Once you are steady, the flat walking routes along the waterfront parks on the Kaka‘ako shore are a sensible place for short early walks, with a companion beside you. Therapy gets going on your first or second day home, with the clinic’s own therapists at Ala Moana or any licensed therapist you choose. The first post-operative check falls around one week out, and after that the implant gets an X-ray every year. The knee recovery guide and the first year after a hip describe the months ahead.