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Frequently Asked Questions About Orthopedic Surgery

By /Published On: February 28, 2021/Last Updated: January 9, 2022/27 words/0.1 min read/
Ask Dr. Morton! | Frequently Asked Questions2022-01-09T09:34:23-10:00

Do you have a question that wasn’t answered here? Schedule an appointment to talk with Dr. Morton. You can also send an email to info@doctormorton.com.

Is it possible for me to obtain a copy of my operative report and x-rays?2022-10-08T21:21:43-10:00

We will provide these documents to you for your records and for any local orthopedic surgeon involved in your care.

Should I arrange for a local orthopedic surgeon to do the follow-up of my joint replacement?2022-10-08T21:19:58-10:00

It is best to have an orthopedic surgeon local to you who would be available to examine you and communicate with us, should the need arise. Follow-up care can be difficult to find someone willing to do for a patient they did not operate on initially; we will assist you as much as possible.

When can I travel out-of-state after surgery?2021-08-01T08:30:29-10:00

Long-distance travel should usually be avoided until at least after your initial post-operative visit with your surgeon. The concern with long-distance travel is the possibility of the development of a blood clot, or missing a postoperative complication.

Once you are on a long trip, Dr. Morton recommends that you get up to stretch or walk at least once per hour during a long trip.  Taking 81mg of aspirin daily is a useful adjunct. Dr. Morton recommends starting aspirin 2 days before your trip, and 2 days after your trip to avoid blood clots. You may want to talk with your primary care physician if you have a history of stomach ulcers, allergies, blood clots, or bleeding disorders. Usually, patients will desire an aisle seat or a lay-flat seat for long distances during their initial recovery.

When can I drive after a hip replacement?2021-08-01T08:24:16-10:00

The answer varies from patient to patient, and whether you have surgery on the right leg or the left leg.  As a general rule, you cannot drive if you are on narcotics or unsafe on the road.  Patients on average are able to return to driving between 2 and 6 weeks after surgery.  I usually advise my patients that if they feel like they wouldn’t be able to stop in the event of an emergency or if a pedestrian suddenly decided to cross the road in front of the car, they should not drive.  Practice on a parking lot before driving on the road.

What Is Dr. Paul Morton’s Fax Number?2021-04-24T16:21:24-10:00

(808)439-6202

What’s the phone number can I call to create an appointment?2021-04-24T16:20:38-10:00

(808)439-6201

Does Dr. Morton see new patients at Queen’s West?2021-04-24T16:18:30-10:00

Dr. Morton’s West Oahu location is at West Oahu Orthopedics at 94-673 Kupuohi St, C205, Waipahu, Hawaii 96797.

How accurate is robotic joint replacement surgery?2021-02-28T20:51:34-10:00

Robotic joint replacement can make bone cuts within 0.5mm of the plan and <1° of expected placement. In comparison, 15-20% of traditional instrumented knee replacements are unable to get within 3° of the expected resection.

I don’t want a robot performing my surgery, I want a human to do it. Does a robot do my surgery?2021-02-28T20:51:15-10:00

Your surgeon is responsible for performing every aspect of the surgery. While the robot assists with improved data collection and bone cuts, the surgeon has to guide the instruments into the right place. The robot is incredibly accurate and prevents surgeons from cutting errors that are imperceptible to the human eye.

Why doesn’t my surgeon perform a robotic assisted surgery?2021-02-28T20:50:53-10:00

Robotic-assisted hip and knee surgery is a newer technology. Not all surgeons were trained in the robot during their training and are not comfortable with learning a new way to perform the same surgery.

Are there any difference in preparing for a robotic hip or knee replacement compared to a traditional joint replacement?2021-02-28T20:50:35-10:00

Some joint replacement systems require special preoperative imaging (CT scan or x-rays). Dr. Morton does not require additional imaging beyond x-rays for his hip or knee replacement surgeries. During surgery two small incisions are made into your thigh and shin to place the robot trackers.

What is the cost to the hospital for robotic hip or knee replacements?2021-02-28T20:49:55-10:00

Pricing programs vary depending on the hospital, implant usage, and physician demand. While a robotic-assisted knee replacement requiring a CT-scan preoperatively will generally cost the hospital an additional $2,000 per patient as reported in some studies, the overall cost to the health system may be decreased due to lower complication rates.

How much does robotic hip or knee replacement cost?2021-02-28T20:49:29-10:00

Patients are not expected to pay any more for their robotic hip or knee replacement. Your bill will be the same from the hospital, regardless if you have a robotic-assisted, or traditional knee replacement.

Are Robotic-Assisted Hip or Knee Replacements Better?2021-02-28T20:50:04-10:00

Robotic assistance allows for more accurate placement of your implant, takes into account the positioning of your anatomy, and personalizing the implantation of your knee. Early and mid-term data from studies demonstrate that robotic-placed implants last longer, recover faster, and have lower amounts of pain overall.

Does knee replacement require an overnight stay?2021-02-28T20:44:57-10:00

Some facilities deem an overnight stay as an “outpatient knee replacement”. Some of our patients may elect to stay overnight or may have medical problems that preclude them from going home on the same day. We do allow many of our healthier patients to go home on the same day as their surgery.

How will I know if I am safe to go home after my knee replacement?2021-02-28T20:44:34-10:00

Your medical history will be carefully evaluated to ensure that you are a good candidate to return home on the same day after your knee replacement. After a discussion with your physician, we will decide if you can return home safely. We make sure that all of our patients work with a physical therapist to ensure that they can safely navigate the obstacles in their home before being discharged.

Can I go home on the same day as my knee replacement?2021-02-28T20:43:08-10:00

Your surgeon will evaluate your medical history and see if you are a good candidate to return home on the day of surgery. With modern medicine, anesthesia, and surgical technique, many of our patients are able to return on the same day as their knee replacements.

Does Dr. Morton accept my insurance?2021-02-28T20:39:21-10:00

Most likely. I accept most insurance plans including HMSA, HMAA, Medicare, Medicaid, MDX, UHA, and United. Call our office to confirm.

Does Dr. Morton accept new patients?2021-02-28T20:38:59-10:00

Absolutely! Call our office today at (808) 439-6201

Where does Dr. Morton Practice?2021-03-21T08:34:09-10:00

Dr. Morton practices in Honolulu, Hawaii at the Queen’s Medical Center, Physicians Office Building 1, Suite 808.

What orthopedic services does Dr. Morton Provide?2021-02-28T20:38:09-10:00

Dr. Morton is a hip and knee specialist who provides clinical and surgical services. His focuses are on joint replacements, complex reconstruction, robotic-assisted surgery, sports surgeries, and trauma care.

What’s the difference between Orthopaedic and Orthopedic?2021-02-28T20:14:02-10:00

Orthopaedic and orthopedic are words that have the same meaning, referring to the same medical specialty. Orthopaedics is the original British word. Orthopedics is the Americanized, more common version. Professional organizations tend to use British spelling, while most physicians in the US use them equally. You can use them interchangeably.

What kind of doctor replaces knees?2021-02-28T20:07:44-10:00
Orthopedic surgeons perform total and partial knee replacement surgery. You should look for someone who is board-certified. While there is no special certification or licensing specific to knee replacement surgery, an ACGME-accredited fellowship can provide assurances in the quality of training that your surgeon received.
How do I pick the best knee surgeon in Hawaii?2021-02-28T20:17:25-10:00

You want an orthopedic surgeon who is specialized in joint replacement, joint preservation, sports injuries, and salvage procedures. You should look for someone who is an expert in minimally-invasive techniques, including the Direct Anterior Approach to hip replacement, and is comfortable in modern techniques such as partial knee replacements and robotic-assisted joint replacements. Dr. Morton can provide you with excellent services as a knee surgeon.

How do I pick the best hip surgeon in Hawaii?2021-08-19T21:24:26-10:00

You want an orthopedic surgeon who is specialized in joint replacement, joint preservation, sports injuries, and salvage procedures. You should look for someone who is an expert in minimally-invasive techniques, including the Direct Anterior Approach to hip replacement, and is comfortable in modern techniques such as partial knee replacements and robotic-assisted joint replacements. Dr. Morton can provide you with excellent services as a hip surgeon.

How do I pick the best/top orthopedic surgeon in Hawaii?2021-02-28T20:17:56-10:00

Dr. Paul Norio Morton is a Board-Certified Orthopedic Surgeon that practices on Oahu and the Big Island. He treats a broad range of orthopedic conditions including arthritis, sports injuries, hip and knee replacements, trauma, and robotic joint arthroplasty. He believes in treating his patients with a holistic approach – incorporating patient’s desires and expectations into the treatment of their musculoskeletal problems.

How do I choose a good Orthopedic Surgeon?2021-02-28T19:59:36-10:00
  1. Credentials: Research your orthopedic surgeon’s credentials. Make sure your surgeon has achieved appropriate education for your orthopedic needs.
  2. Experience: Discuss with your orthopedic surgeon their experience with the particular surgery
  3. Hospital Quality: Make sure that you are comfortable at the hospital where you may have your operation. Check the US News site for hospital ratings.
  4. Communication: Some patients enjoy a friendly doctor, others are looking for a more paternalistic approach.
  5. Reviews: Research other’s experiences by looking at their reviews online
  6. Insurance: Not all doctors will take your insurance. Check before making your appointment
  7. Comfort: If you’re not comfortable with your orthopedic surgeon, look elsewhere.
Where is the best hospital to have orthopedic surgery in Hawaii?2021-02-28T20:02:19-10:00

The Queen’s Medical Center is ranked #1 in Hawaii by the USNews and high performing at both Hip and Knee replacements.

Do I need physical therapy after my injury or surgery?2021-02-28T18:19:05-10:00

Physical therapists do an excellent job of helping patients reach their full potential. They have advanced degrees in understanding body mechanics and helping you recover and get your life back to normal. If you have questions about what exercises you can do on your own, or why a therapist might be necessary, talk with Dr. Morton

I didn’t get my post-op physical therapy protocol.2021-02-28T18:18:44-10:00

Please download a copy of it here. If there’s a protocol not listed here, talk with Dr. Morton.

Do you have physical therapy in your clinic?2021-02-28T18:18:27-10:00

We do not formally own a physical therapy clinic. However, we have excellent relationships with many physical therapist offices.

What if I don’t want surgery for patellar maltracking?2021-02-28T18:15:08-10:00

Fortunately, most forms of patellar maltracking can be treated without surgery. An extensive course of physical therapy can often resolve the pain and stabilize the kneecap. If you have a form of maltracking that requires surgery for treatment, you should talk to an orthopedic surgeon.

What happens if I don’t address patellar maltracking?2021-02-28T18:14:34-10:00

Most cases are able to be treated without surgery. Sometimes, severe patellar maltracking can cause structural damage to the joint, resulting in pain, cartilage loss, and osteoarthritis. Over time, arthritis can interfere with a person’s life to the extent that they get the joint replaced.

I have knee pain. How do I know I have patellar maltracking?2021-02-28T18:14:50-10:00

Patellofemoral syndrome, or patellar maltracking is prevalent. Pain is often in the front of the knee, worse with stairs. Xrays may show the knee cap tilted to the side.

How long does a partial knee replacement last?2021-02-28T18:08:24-10:00

Partial knee replacements that are done for the right reasons can last a lifetime. Patients who are heavier, have a higher activity level, or have arthritis in other areas of their knee are at a higher risk for failure. At 10 years, 90% of partial knees done with historical techniques are still functioning well. Using robotic assistance, surgeries are able to have their implants placed in better positions, and the longevity approaches that of total knees, while maintaining the improved kinematics from a partial knee.

Who is a candidate for a partial knee replacement?2021-02-28T18:08:01-10:00

Partial knee replacements are a good surgical option for patients who have to isolated osteoarthritis to only one compartment. The knee is made of three compartments – medial, lateral, and patellofemoral. Partial knee replacements in patients with arthritis in more than one compartment are at high risk of failure after a partial knee replacement.

What can I expect with a partial knee replacement?2021-02-28T18:07:30-10:00

Comparatively, there is less surgery associated with a partial knee replacement. This results in less blood loss, less pain, and quicker recovery. Patients are generally able to return home on the same day of surgery. You are able to shower right away. After about 6 weeks, most patients are able to return to many of their normal activities.

What is the normal recovery time for a partial knee replacement?2021-02-28T18:07:09-10:00

Recovery from a partial knee replacement is generally faster compared to a total knee replacement. Partial knee replacements usually recover between 4 and 10 weeks. Total knee replacements can take between 8 to 12 weeks for a recovery.

Do I need a card when I go to the airport? Will I set off the metal detectors?2021-08-01T08:34:23-10:00
You do not need a card after your new hip or knee replacement. After all, if you were a terrorist – they would still have to scan you. They will still let you fly, even if you don’t have a card. You will have to let the TSA agent know that you have a metal implant in your knee.
Is blistering around my incision normal after knee replacement?2021-02-28T18:04:40-10:00

Blistering can be a side effect of the bandages or swelling after your replacement. Blistering is a rare phenomenon. If you have blistering, please call me to make sure that there are no complications to be concerned about.

Is bruising normal after knee replacement?2021-02-28T18:04:23-10:00

Yes. In order to implant your new knee, we have to move the muscles and soft tissue to the side. Cutting the bone can cause a significant amount of blood flow. This will cause a large amount of bruising and discoloration after surgery.

My friend got a Continuous Passive Motion (CPM) machine after surgery. Why didn’t I get one?2021-02-28T18:04:04-10:00

These devices have fallen out of favor in the orthopedic community. We have found that these devices are expensive and have not made a difference in return to motion after a knee replacement. These have not been used for years by most orthopedic surgeons.

I have numbness on the outside of my knee after my replacement. Is this normal?2021-02-28T18:03:46-10:00

During a knee replacement, we cut through the infra-patellar branch of the saphenous nerve. This nerve is responsible for the sensation on the outside of your knee. This usually disappears slightly with time, but you will always have a numb area there. Some patients can develop a painful neuroma. I am happy to talk about any of your concerns about this numbness.

When can I return to work after surgery?2021-08-01T08:31:36-10:00

This is a complex question depending on what job type you are doing.

Desk job: I tell most patients that they will feel well enough to begin working around two weeks after surgery. Some patients who are gung-ho will even start working immediately after surgery.

Light Labor: Light labor that requires frequent walking or light lifting. Some patients may require 6 weeks to 3 months before returning to work. Close monitoring will be needed to help you determine when you are safe.

Heavy labor: Construction and other types of manual labor usually requires at least 3 months of recovery. Some patients will have to change their careers depending on their demands. Talk with your surgeon before returning to work.

How quickly will I be up after a knee replacement?2021-02-28T18:03:01-10:00

We have our patients walking on the same day. patients who are expected to go home will have a course of physical therapy in the post-op unit to ensure that they are safe to go home.

When can I drive after a knee replacement?2021-02-28T18:02:37-10:00

This depends on if you drive a manual transmission car, and if your replacement involves your right or left knee. Patients who undergo a right knee replacement are going to take longer to start driving – sometimes up to 6 weeks.

I allow patients to drive when they reach the following goals: 1. No significant pain while driving, 2. No longer taking narcotics, 3. Able to stop in the event of an emergency such as a small child crossing the road.

Most patients are able to achieve this with a left knee replacement around two-weeks after surgery.

Do I need to go to a skilled nursing facility or rehab after knee replacement?2021-02-28T18:02:11-10:00

Modern knee replacements are performed on an outpatient basis. Many patients are able to go home on the same day, and sometimes the following day. This is because our pain control and anesthesia have significantly improved. Some patients who do not have adequate support at home will require a skilled nursing facility to recover until they are strong.

How long will the operation take?2021-02-28T18:01:49-10:00

Time is relative. For patients undergoing a knee replacement – it will be as if no time has passed, as they will be asleep. For family members in the waiting room, it can be a couple of hours before they have a chance to see their loved ones, depending on the anesthesia used. For me, it usually takes between 30 minutes to an hour to perform a knee replacement depending on patient anatomy. This is because I perform all parts of the operation, including exposure, implantation, and closure.

Do I need custom implants for my joint replacement?2021-02-28T18:01:17-10:00

Custom implants and customized jigs are a technology that has not demonstrated to have brought significant value for patient outcomes. These devices have not been demonstrated to be more reliable than traditional knee replacements. It is likely because it does not take into account your soft-tissue anatomy at the time of surgery. This is the difference that robotic joint replacements provide.

How close before surgery can I have an injection in my knee?2021-02-28T18:00:18-10:00

While the science is conflicting on whether injections are associated with infected knee replacements, many insurance companies have made limitations on joint replacements after injections. If you have an injection, most insurance companies will not support payment for a knee replacement for 3 months after your injection. This is with the health of our patients in mind. Avoidance of infection is of utmost importance as an infection can have devastating consequences.

Is it necessary to have a robot assist with the surgery?2021-02-28T17:59:30-10:00

Robotic joint replacements are a hot-topic in hip and knee replacements. While you may not need a robot to perform your surgery, robotic knee replacements are able to provide a much more accurate positioning of your knee replacements and personalize the implantation to your anatomy. Much like anterior hip replacements are able to position our implants better and improve outcomes, I believe that robotic joint replacements can make the same improvements for knee replacements.

Should I have a partial (uni) or total knee replacement?2021-02-28T17:58:52-10:00

Partial and total knee replacement surgery have excellent track records. There are risks and benefits to both operations. Partial knee replacements often leave patients with a more “natural feeling” knee, while total knee replacements are able to provide the longest term result with lower risk of re-operation.

When can I go to the dentist after my knee replacement?2021-02-28T17:58:25-10:00

I usually recommend that people wait three months prior to having any dental work done. Please ask for antibiotics, especially within the first year of your surgery.

Should I quit smoking before my joint replacement?2021-08-01T08:33:38-10:00

Tobacco use is known to be a significant risk factor for loosening, infection, or wound healing problems. Minimizing your tobacco use or quitting before surgery will make a significant impact. If you are able to quit for life, you will significantly reduce your risk of other complications to your overall health as well. Learn more about tobacco effects on joint replacements here.

Should I have bariatric surgery before my knee replacement?2021-02-28T17:57:24-10:00

Some patients find that once they lose a significant amount of weight after bariatric surgery, they do not need to see an orthopedic surgeon for a knee replacement. If you are able to successfully lose enough weight before surgery, you may also reduce the chance of a complication after your surgery. Obtaining a healthy weight should be your goal.

Do I need to get my bad teeth fixed before surgery?2021-02-28T17:57:07-10:00

Infections in your mouth are a significant risk factor for a knee replacement infection. We recommend that any evidence of a dental or gingival infection be addressed prior to surgery. Some clinics even require mandatory dental clearance prior to surgery. After surgery, we will often provide patients with antibiotics prior to deep cleaning or any major dental work.

Should I lose weight before knee replacement surgery?2021-02-28T17:56:41-10:00

Even if you feel fit and healthy, you may be asked to lose weight before knee replacement surgery if you are heavier. Much of the research on complications following knee replacement surgery has been focused on patients with a high body mass index (BMI). In fact, Queen’s Medical Center will not allow the scheduling of any surgery of patients with a BMI greater than 40. This is because patients who are heavier are at higher risk for the following complications:

– Infection

– Component loosening

– Poor wound healing

– Blood clots

– Pulmonary embolism (blood clot travels to the lung)

Typically, we ask patients to aim for a BMI that is less than 40 prior to surgery. We would prefer patients to obtain a BMI less than 35 as this will significantly lower your risk profile.

Can I run or jog after a knee replacement? What kinds of sports activities can I be involved in?2021-02-28T17:56:16-10:00

Running can put a tremendous amount of stress across your new implant. I would be very careful before starting a heavy-exercise program on your new knee replacement. Despite this, you can still be an athlete and do certain types of activities. The American Academy of Orthopaedic Surgeons (AAOS) recommends the following activities with a total knee:

– Bicycling

– Calesthetics

– Swimming

– Low-resistance rowing

– Gentle Skiing

– Walking & Hiking

– Low-resistance weightlifting

Similarly, the AAOS advises against high-impact activities:

– Baseball

– Basketball

– Football

– Hockey

– Soccer

– High-impact aerobics

– Gymnastics

– Running and Jogging

– Powerlifting

Am I too young for a knee replacement surgery?2021-02-28T17:55:53-10:00

Traditionally, knee replacements were reserved for patients who were elderly with severe knee arthritis. Concerns regarding patients who undergo knee replacement at a younger age are focused on the wear of the knee replacement components. Any patient who is in their 40’s and 50’s is considered “young” for a knee replacement. However, they may still be a candidate for a knee replacement if they understand the limitations of the implant and have failed non-operative treatment.

The average age of patients today undergoing a knee replacement is 65 years old. While patients under the age of 50 are the fastest-growing segment of the population undergoing knee replacement surgery, many orthopedic surgeons have reservations.

How long does a knee replacement last?2021-02-28T17:55:30-10:00

Modern knee replacements have made a drastic improvement with the invention of highly cross-linked polyethylene. Polyethylene is the plastic component within your knee replacement. Traditionally, these plastic components are expected to last up to 20 years in 90% of people. With newer plastic components, we are hopeful that knee replacements will last even longer.

There are newer knee components including those made from Vitamin E or ceramic, which may reduce the wear of the plastic component.

The length of time that a knee replacement will last is variable. While the current generation of knee implants are expected to last most of our patient’s lifetimes. Orthopedic surgeons worry that high levels of activity, weight, or other complications such as infection or loosening could lead to the need for revision.

Can you walk with a torn meniscus?2021-02-28T08:44:54-10:00

Usually. Walking is unlikely to cause further damage to your knee. A bucket-handle meniscus tear that is impinged may limit your ability to walk. Call to schedule an appointment if you are concerned at 808.439.6201.

How long does a meniscus take to heal without surgery?2021-02-28T08:44:04-10:00

Results are variable. Dr. Morton may offer you a steroid shot and a course of physical therapy. This is designed to help you improve your strength and reduce your inflammation. Usually, the pain can improve over the course of 1 to 2 months.

What happens if you leave a torn meniscus untreated?2021-02-28T08:43:20-10:00

A large repairable tear untreated may go on to develop arthritis years later. Arthritis can be a serious problem and a source of debilitating pain. For patients who already have a degenerative tear, a torn meniscus may eventually become asymptomatic. If you continue to have symptoms, Dr. Morton can offer to remove the offending meniscus.

Can a meniscus tear heal on its own?2021-02-28T08:42:58-10:00

This depends on the size or location of the tear. A large tear causing impingement like a bucket-handle tear is less likely to heal on its own and is likely to need surgery. Small degenerative tears often will stop being symptomatic after a short period of conservative treatment.

I have an MRI, do I really need an x-ray of my knee?2021-02-28T08:28:35-10:00

MRIs are good at showing soft tissues. Injury to cartilage, ligaments, and meniscus can be seen on an MRI. X-rays are better at showing bone anatomy, alignment, and arthritis.

How long does it take to recover from a knee injury?2021-02-28T08:28:09-10:00

A simple injury such as a sprain or strain can heal over the course of one or two weeks. More serious injuries can take several weeks to months to get better. These more serious injuries often require intervention by an orthopedic surgeon to help you recover.

Why does my knee hurt?