Hip & Knee Replacement for Patients in Pearl City, Hawai‘i

Second opinions for Pearl City patients cover two situations. In the first, someone has recommended a hip or knee replacement and you want it confirmed before you commit. In the second, a knee or hip was already replaced, here or somewhere else, and it still hurts. Either way, Dr. Morton starts with what usually answers the question: a hands-on exam and weight-bearing X-rays, both of which the Kunia clinic can do in one visit. An MRI comes later, and only if a specific question is still open.

He reviews every image himself, reads the operative notes and implant records, and sends a written impression with plan options, typically within one to two weeks. Imaging done in Hawai‘i can usually be requested electronically. If you have discs or digital copies, you can upload your images (opens in a new tab) before the appointment; that is not a review and does not reserve a time. There is no pressure to switch surgeons. See the second opinion page.

Climbing the streets of Pacific Palisades, or simply the stairs at home, is work for the quadriceps. Dr. Morton spares that muscle’s tendon by using the subvastus approach for nearly every total knee, entering beneath the muscle instead of through it. A different route may be needed for a very muscular or tight knee, a marked deformity, scar tissue from a past operation, and in most revisions. Primary knees are done without a tourniquet.

Alignment is set to your own leg and ligament balance, kept within published safe-zone limits, and long-term durability data for that personalized method is still being gathered. If X-rays point to strong bone and the operating room confirms it, the parts are fixed without cement; where bone is weaker, cement is used, and it carries the longer track record. You sign consent for both options. The knee replacement hub and the alignment section of Dr. Morton’s philosophy page go into detail.

Dr. Morton replaces hips through the direct anterior approach as his standard. He reaches the joint from the front, opens the capsule, and leaves every muscle attached, which is why most of his hip patients do not get a list of positions to avoid. Whether home is up on the Palisades ridge or down near the shoreline, that means fewer rules about bending and sitting in the first weeks. He will recommend a different approach when it is safer: a hip that has had surgery before, hardware still in the bone, a significant deformity, a large skin fold over the front of the hip, or a past problem with wound healing.

A bikini-line incision may be offered when your anatomy allows; if he needs more room, he lengthens it into a standard anterior incision rather than accept a less exact implant position. Implants are chosen for your bone and your risk of dislocation, never by brand. Read the hip replacement overview.

If the cartilage loss sits in just one compartment, a partial knee replaces that section alone and leaves the ACL in place. Good candidates usually share a few features: arthritis limited to that one area, a working ACL, a knee that still gets straight, only mild deformity that can be corrected, and pain that persists through therapy, medication and injections. Wear across two or three compartments, an ACL that is torn or gone, inflammatory arthritis such as rheumatoid arthritis, or severe deformity favors a total.

Dr. Morton performs all four types (medial, lateral, patellofemoral and bicompartmental), planning each in 3D and using robotic assistance, a smaller incision and no tourniquet. Partials do come back for revision somewhat more often over the years; a later conversion to a total is generally less involved than revising a failed total, but it is a revision all the same. Age by itself does not decide; an exam and same-day standing X-rays at Kunia do. Compare the two on the partial vs total page.

Robotic assistance is the way Dr. Morton carries out a plan, not a separate service. He maps your joint in 3D before surgery; in the operating room, the robot keeps the work matched to that map and feeds back alignment and balance measurements, while he makes every cut and every decision. On O‘ahu the platform is selected to fit your case and the venue. At Queen’s that means ROSA®, which works from standard X-rays rather than a CT scan.

For Pearl City patients on Medicare, the useful detail is billing. Robotic assistance is billed as standard joint replacement, so there is no technology fee and no separate patient charge, and Medicare coverage is unchanged. Dr. Morton is certified on ROSA, Mako, CORI and VELYS, and in 2022 he performed the first robotic-assisted total hip replacement in Hawai‘i. Read more about his background and about ROSA.

A knee replacement that still hurts months or years later has a cause, and Dr. Morton’s Revision Hip & Knee Clinic looks for it before anyone talks about surgery. Possible culprits include loosening, infection, instability, scar-tissue stiffness, wear with bone loss, a component sitting in the wrong position, a fracture around the implant and a reaction to metal debris. The workup sets current X-rays against older ones, measures ESR and CRP, cultures joint fluid when infection is a concern, adds metal-artifact-reduction MRI or CT if needed, and confirms which implant you have and whether it was recalled.

When bone has been lost, rebuilding it is a planned part of the reconstruction: porous metal augments, cones or sleeves fill defects, and revision stems reach solid bone for fixation. Revisions are scheduled at a hospital, mainly Queen’s, usually with a short inpatient stay. See revision knee replacement.

The Kunia clinic is in the Kunia Shopping Center, with free parking steps from the door. It handles consultations, injections, imaging and follow-ups, and therapists work in the same building. If you twist a knee or suspect a fracture before your appointment comes up, Wiki Wiki Orthopedics in the same center takes walk-ins and has X-ray on site; call first to confirm that day’s hours. If a town visit suits you better, the Ala Moana clinic is available too.

Dr. Morton leads every surgical decision and performs the operation himself, and along the way you will also work with his physician assistant, nurses, physical therapists and the anesthesia team. The venue is chosen with you based on procedure, health and insurance, and complex or higher-risk cases are usually scheduled at The Queen’s Medical Center. Most new patients are seen within one to two weeks of calling (808) 439-6201. Neighbors in ‘Aiea and ‘Ewa Beach use the same clinic.

The Pearl Harbor Historic Trail is one of the better reasons to recover at home. Its flat, paved surface along the shoreline suits the short, frequent walks of the early weeks, first with a walker, which most people use for about the first couple of weeks, then with a cane once balance improves. Leave the hills of Pacific Palisades for later in your recovery.

Physical therapy begins on the first or second day home. You can do it at the Kunia clinic, where the therapists follow Dr. Morton’s protocols, or with any licensed therapist you prefer; the office can suggest some and sends the written protocols to them. Plan on a follow-up visit around one week after surgery, and expect some later checks by Doximity video on your phone. Most patients take aspirin for several weeks to guard against clots, about a month after a knee. For what to expect with walkers and canes, see the travel guide’s mobility aids section.