Ask Dr. Morton
The questions everyone asks — answered straight
No jargon, no scare tactics, no sales pitch. If your question isn't here, bring it to your consultation — Dr. Morton answers everything.
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Straight answers, from the surgeon
The answers below reflect how Dr. Paul Morton — fellowship-trained hip & knee surgeon and founder of Pacific Bone & Joint in Honolulu — actually counsels his own patients. Your situation is unique; a consultation makes it specific to you.
Deciding on surgery
How do I know when it’s time for a joint replacement?
When pain limits the life you want to live despite reasonable non-surgical care — therapy, activity modification, medication, injections — it’s time to talk. X-ray severity matters less than how your joint affects your days. A consultation doesn’t commit you to surgery; it gets you an honest map of your options.
Am I too young (or too old) for a hip or knee replacement?
There’s no strict age cutoff in either direction. Modern cementless implants and precise robotic alignment have made replacement far more durable for younger patients, and healthy patients in their 80s and beyond regularly do well. Health, goals, and anatomy drive the decision — not your birth year. See our article "Am I Too Young for Hip Replacement?" for details.
What are the alternatives to joint replacement?
Depending on your joint and stage of arthritis: physical therapy, weight optimization, anti-inflammatory strategies, bracing, cortisone or hyaluronic-acid injections, PRP and BMAC orthobiologics, and arthroscopic or preservation procedures. Dr. Morton offers all of these — surgery is recommended only when it’s genuinely the best option.
What is a partial knee replacement, and am I a candidate?
If arthritis is confined to one compartment of your knee, only that compartment is resurfaced — preserving your ligaments and healthy cartilage for a more natural-feeling knee and quicker recovery. Roughly one in four knee-arthritis patients is a candidate; a standing X-ray series and exam give the answer.
Robotics & technology
Does the robot do my surgery?
No — Dr. Morton performs every step. The robot — for knees, ROSA® primarily at The Queen’s Medical Center and CORI at Adventist Health Castle; for hips and knees, Mako at Hilo Community Surgery Center — is a precision instrument: it turns a personalized 3D plan of your joint into exact cuts and implant positioning, and gives live feedback on alignment and soft-tissue balance during surgery. Think of it as GPS plus power steering for a surgeon who already knows the road.
Is robotic joint replacement worth it? Does it cost more?
Robotic assistance costs you nothing extra with Dr. Morton — it’s billed as part of the operation. Published studies associate robotic assistance with more accurate implant placement, less soft-tissue trauma, and faster early recovery.
What is the Persona IQ® smart knee?
The first FDA-authorized (De Novo, 2021) smart knee implant: sensors in the tibial stem record steps, walking speed, and range of motion and send them securely to your care team. Dr. Morton placed Hawai‘i’s first in October 2022; he offers it only when he is using Zimmer Biomet implants, and then case by case.
What does "cementless" mean, and is it better?
Cementless implants have porous surfaces your own bone grows into — biologic fixation instead of acrylic cement. For patients with good bone quality, that living bond may offer better long-term durability, which especially matters for younger, active patients.
Surgery & recovery
How soon will I walk after surgery?
The same day, for most patients. Muscle-sparing approaches, tourniquet-free technique, and multimodal anesthesia mean your leg works when surgery ends — physical therapists usually have you up within hours.
How long is the hospital stay?
Many patients go home the same day or within 24 hours through the outpatient joint replacement program. Patients with more complex health needs may stay a night or two — the plan is personalized, never one-size-fits-all.
How much pain should I expect, and will I need opioids?
Dr. Morton’s opioid-sparing protocol combines regional anesthesia, long-acting local blocks, anti-inflammatories, and techniques that create less tissue trauma in the first place. Most patients need dramatically fewer opioids than they fear — some none at all after the first days.
When can I drive, return to work, and travel after joint replacement?
Typical milestones: driving at about 2–6 weeks on average (only once completely off narcotics, with safe reaction time; sooner for a left hip or knee with an automatic transmission), desk work at 1–3 weeks, physical work at 6–12 weeks, and air travel around 2 weeks with precautions. Golf commonly returns around 6–12 weeks, hiking by 3 months. Your timeline depends on your joint, your job, and your recovery.
Will my new joint set off airport metal detectors?
Probably — most joint implants do. You don’t need a doctor’s card; just tell the TSA officer you have a joint replacement. Body scanners identify implants quickly and it adds only moments to screening.
Do I need antibiotics before dental work after a joint replacement?
Routine dental cleanings generally don’t require antibiotics for most healthy patients, but recommendations vary with your health history and how recent your surgery was. Dr. Morton advises waiting about three months after surgery for non-urgent dental work — and will give you a personalized protocol. If you are high risk or need emergency dental work, contact our office first.
Cost, insurance & access
How much does hip or knee replacement cost in Hawai‘i?
With insurance, your out-of-pocket cost is set by your plan — often far less than patients fear. Without insurance, hospital list prices in Hawai‘i can exceed $40,000–$100,000, but transparent self-pay packages can cost dramatically less. See the cost guide and self-pay pages for real numbers.
Which insurance plans do you accept?
Most major plans: HMSA, Medicare, Medicaid/Quest, AlohaCare, UHA, HMAA, United Healthcare, Aetna, Cigna, Humana, TRICARE, VA Community Care, Kaiser Added Choice referrals, and more. Managed-care plans may require a PCP referral — call us and we’ll verify your coverage.
I live on a neighbor island or outside Hawai‘i. How does that work?
Hawai‘i Island patients are seen in person at the Hilo and Kona clinics. When a clinic isn’t within reach, you can start by telehealth if you’re in Hawai‘i, with imaging arranged near home, or with a pre-travel video call that reviews your records and imaging if you’re outside Hawai‘i; either way, your in-person care is bundled into one trip. Patients regularly travel from Hilo, Kona, Maui, Kauai, Guam, Saipan, American Samoa, the Philippines, Japan, Korea, and beyond. See the destination surgery program.
What is the PBJ Rapid Recovery Concierge?
It is the recovery program around a hip or knee replacement: precise surgical planning (robotic-assisted for knees, and for Mako hips in Hilo), a strategy built to control swelling and inflammation, and coordinated care before and after surgery. Every patient starts with Your Surgical Care — expert hip and knee surgery and all medically necessary care, billed to insurance, with no fee and no membership required. On top of that, three optional membership levels add non-covered support — coordination, equipment, travel help and access: Accelerated Recovery, Concierge Recovery and Elite Recovery. Membership is optional, does not change your place on the surgical schedule, and your medical care is identical either way. See the Rapid Recovery Concierge program.
Still have questions?
Bring them all to a consultation — in person or by telehealth. You'll leave with answers and a plan.
Online scheduling opens Klara, our secure booking service; a real person confirms within one business day.
Paul Norio Morton, MD, FAAOS, FAAHKS · Hawai‘i’s first robotic hip & smart knee · Read patient reviews →
Most major plans accepted — we verify benefits before your visit. Traveling from off-island? See the fly-in patient program →