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

The right moment for a second look is before a date is set: when a total knee has been presented as the only choice, when a hip operation is booked but your questions are not, or when a joint replaced years ago now aches with the first steps of the morning. Living in Kapolei, you can get that look without spending a day in Honolulu. Dr. Morton holds second-opinion visits at Kunia, studies your X-ray, MRI or CT images himself rather than trusting a summary, and examines the joint. You typically have his impression and your options in writing within one to two weeks.

Send the image files, not only the reports. The practice’s portal lets you upload your images (opens in a new tab) before you come, so they are on hand at Kunia, though putting them there is neither a review nor a booking. Nobody expects you to switch surgeons. A checklist of what to collect sits on the second opinion page.

On nearly every total knee, Dr. Morton slips beneath the quadriceps instead of splitting its tendon, the subvastus or quad-sparing approach. That is the muscle that carries you up a sloping Makakilo street and out of a low chair. He sets the approach aside when a knee is unusually tight or heavily muscled, badly deformed, scarred by a previous operation, or being revised. First-time knees are done without a tourniquet, through an incision that usually measures four to six inches.

Implant position is tailored to how your own leg lines up and how your ligaments balance, kept within published safe zones; long-term data on this personalized method is still coming in. Cement depends on bone quality. Good bone, judged on X-ray and checked at surgery, takes cementless components; weaker bone is cemented, the method with the longest record behind it, and your consent covers either. See the knee replacement hub and the subvastus page.

With the direct anterior approach, his standard for hips, Dr. Morton reaches the ball and socket by opening the joint capsule alone; no muscle is cut or lifted off the bone, and hip precautions are usually unnecessary. A few situations make another route safer: a previous operation on that hip, hardware left from an old repair, a hip that is significantly deformed, a heavy skin fold hanging over the front, or wounds that have healed poorly before. He tells you if one applies.

Thinking about the Ko Olina lagoons? A bikini-line incision, placed where a swimsuit covers it, is possible when your anatomy allows. If he needs more room, he lengthens it to a standard anterior incision rather than accept a less exact implant position. Robotic guidance on essentially every hip maps the cup angle, stem size, leg length and offset. The usual construct is a titanium cup, a cross-linked polyethylene liner and usually a ceramic head, without cement when bone allows; brands play no part.

Whether a partial knee is realistic can often be answered at the first Kunia appointment, with standing X-rays taken there and an exam; an MRI is ordered only if a specific question is left over. A partial resurfaces only the damaged part and keeps the ACL. Good candidates have arthritis in a single compartment, a working ACL, a knee that can still straighten well, a modest angle that corrects, and pain that has outlasted therapy, medicines and injections. A total fits better when two or three compartments are worn, the ACL is torn or missing, the arthritis is inflammatory (rheumatoid, for example), or the knee is badly deformed.

He does medial, lateral, patellofemoral and bicompartmental partials, each mapped in 3D and performed robotically through a shorter, tourniquet-free incision. Over a lifetime a partial is somewhat more likely to need revising. Converting one to a total is usually less involved than redoing a failed total, but it still counts as revision surgery. Age alone does not settle it. See the partial vs total knee page.

The robot in Dr. Morton’s operating room is a guide, not a surgeon. Ahead of time he maps your joint in 3D, so the plan is drawn up before you head into town for surgery. During the operation the system holds him to that plan and feeds back alignment and soft-tissue balance in real time. It cannot cut on its own, it makes no choices, and every step is performed by him. On O‘ahu the platform depends on the case and hospital; at Queen’s it is ROSA®, which works from ordinary X-rays and needs no CT scan.

Dr. Morton holds certification on four robotic systems (ROSA, Mako, CORI and VELYS). In 2022 he did the first robotic-assisted total hip replacement in Hawai‘i, and his patients know him as “The Robot Doc.” You pay no technology fee and no separate charge for the robot; it is billed like any standard joint replacement, and Medicare coverage stays the same. Read about robotic knee replacement and robotic hip replacement.

When a replaced joint feels loose, hurts as you push up from a chair, or wakes you at night, the Revision Hip & Knee Clinic works out why before anyone talks about surgery. Roughly half of Dr. Morton’s practice is revision work sent by other surgeons, and he routinely sees implants put in elsewhere, including the mainland and overseas. The investigation runs in a set order: fresh X-rays laid beside earlier films, ESR and CRP blood work, a needle aspiration and culture if infection is on the table, metal-artifact-reduction MRI or CT for questions still open, and a check of the implant’s make, size and any recall.

Findings vary: a loose or infected component, an unstable joint, worn plastic with bone loss, a fracture beside the implant, a metal-debris reaction, a stiff knee, or malpositioned parts. Sometimes the pain is traced to the spine or a tendon, and surgery is not the answer. Needed revisions happen in a hospital, Queen’s for most and Castle for some, usually with a short inpatient stay.

The Kunia clinic is your home base. It sits in the Kunia Shopping Center with free parking and easy access to H-1 and H-2, and covers consultations, imaging, injections, the pre-operative visit and follow-ups. Justin Grandalen, PA-C, sees patients alongside Dr. Morton, so some visits and in-between questions go through him; ask any time if you want Dr. Morton himself. Hurt a knee while you wait? Wiki Wiki Orthopedics, the practice’s walk-in orthopedic urgent care with X-ray on site, shares the center; phone first to check its hours that day.

The H-1 drive east is saved for surgery. You and Dr. Morton pick the hospital together, weighing the operation, your health and what your plan covers. Revisions, complex cases and higher-risk patients typically go to Queen’s; Adventist Health Castle in Kailua is the other choice. Both can send qualified patients home the same day or keep you overnight when your health calls for it. To book, phone (808) 439-6201 or tap Schedule; new patients are usually seen within one to two weeks.

Most people are up with a walker on surgery day and move to a cane after about the first couple of weeks. Therapy picks up a day or two after you get home, in the house or at a clinic, and the place is your choice: PB&J Physical Therapy works in-house at the Kunia clinic, or you can pick any licensed therapist easier to reach from Makakilo, Kalaeloa or Ko Olina. The office can recommend names and forwards Dr. Morton’s written rehabilitation protocols so your therapist follows his plan.

When you are steady and your team gives the go-ahead, the walking paths around the Ko Olina lagoons are an inviting place to stretch your walks. Getting into the lagoon water waits for clearance: typically about six weeks out from a knee, and nearer three months for the ocean after a hip. The first check comes around a week after surgery, some later ones happen by Doximity video on your phone, and a yearly X-ray keeps tabs on the implant for life.