01
Tell the story
Dr. Morton starts with what happened, what has changed, what you have already tried, and what you need your body to do again.
Orthopedic injections
Injection options without guessing at the pain source.
Injections can be useful, but only when we know what we are treating. Knee pain, hip pain, tendon pain, arthritis, and referred pain can feel similar and need different plans.
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How the visit works
You should leave with a clearer plan than when you arrived.
02
Look at the source
Your exam and imaging help separate arthritis, injury, implant problems, referred pain, and other causes that can feel similar.
03
Choose the next step
The plan may be therapy, bracing, injections, orthobiologics, arthroscopy, robotic surgery, revision workup, or a clear reason to wait.
Before you book
The first visit is better when the story is organized.
Joint Replacement Hawaii has always asked practical questions before the appointment because the details matter: what hurts, where it hurts, what you have tried, and what life activity you want back.
01
What are you having trouble with?
Getting in and out of a car
Getting up from a chair
Stairs
Walking long distances
Pain at night
Exercise, sports, or work
02
What are you noticing?
Swelling
Instability or giving way
Stiffness or limited motion
Catching or locking
Grinding
Difficulty bearing weight
03
What have you already tried?
Physical therapy
Brace, cane, walker, or crutches
Steroid or gel injections
PRP or BMAC questions
NSAIDs or Tylenol
Prior arthroscopy or surgery
Before you decide
The conversation I want patients to understand.
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When injections help
An injection may calm inflammation, help with pain, buy time, or help confirm where pain is coming from.
02
What we compare
We compare steroid, gel, PRP, BMAC, therapy, bracing, medications, arthroscopy, replacement, or waiting when appropriate.
03
When injections are not enough
Advanced arthritis, deformity, locking, instability, infection concern, or a painful implant may need a different workup.
How I think through the recommendation
The decision should be explained, not handed to you.
Patients should know what would make us wait, what would make treatment reasonable, what might require more testing, and what changes recovery planning.
01
What may make us wait
- Diagnosis is not clear enough for an injection
- Symptoms are improving with simpler care
- Cost, coverage, or expectations need more discussion
02
What may make PRP or BMAC reasonable
- Mild or moderate arthritis with realistic goals
- Tendon, ligament, or joint-preservation problem fits
- The patient understands limits and aftercare
03
What may mean more tests
- X-rays are needed to stage arthritis
- MRI may be needed for meniscus, tendon, or cartilage questions
- Severe deformity or instability changes the conversation
04
What changes aftercare
- Activity modification after injection
- Response tracking over weeks to months
- Clear plan if symptoms do not improve
Injection decision guide
Start with what we are treating, then choose the injection.
BMAC, PRP, gel, steroid injections, braces, therapy, arthroscopy, and replacement are not interchangeable. I explain the options after we know the target and the severity of the problem.
Think about 01
Name the target
Tendon pain, mild arthritis, bone-on-bone arthritis, meniscus injury, and referred pain all need different conversations.
Think about 02
Know the tradeoffs
Cost, insurance, timing, aftercare, and expected response are part of the decision, especially for PRP and BMAC.
Think about 03
Avoid miracle claims
I do not promise cartilage regrowth. If an injection is unlikely to help, I want patients to hear that clearly.
For informed patients
The details matter, especially when the decision is not simple.
If you are comparing surgeons, robotics, revision care, injections, or recovery plans, these are the questions I want you to feel comfortable asking.
01
Candidacy first
PRP and BMAC depend on diagnosis, arthritis severity, alignment, tissue quality, and expectations.
Imaging reviewCost and coverageAftercare plan
02
No miracle claims
The visit should avoid promises about cartilage regrowth and compare injections with therapy, bracing, arthroscopy, replacement, or waiting.
Honest limitsOptions comparedFollow-up if symptoms persist
Patient words
The trust signal should match the decision.
Patients are looking for listening, clear explanations, office kindness, and a plan that makes sense for their specific problem.
Patient trust
PRP and BMAC deserve honest counseling.
Some patients are good candidates. Some are not. The conversation starts with diagnosis, imaging, arthritis severity, cost, and expectations.
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BMAC and PRP education
02
Candidacy before treatment
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No miracle claims or guaranteed cartilage-regrowth language
You may be ready to schedule if
Arthritis flare or activity-limiting pain
Trying to delay surgery when reasonable
You want to compare steroid, gel, PRP, or BMAC
Prior injection wore off
You need to understand timing before possible surgery
Why patients choose this practice
PRP and BMAC are discussed only after diagnosis and imaging review
Regenerative options are explained without cartilage-regrowth promises
Surgery, therapy, bracing, injections, and waiting can be compared honestly
Older patients and caregivers
Older patients and caregivers deserve a clear plan too.
Safety, medications, stairs, rides, hearing, memory, home help, and caregiver questions can change the recommendation and the recovery plan.
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Who should come with you
Bring the person who helps with medications, rides, meals, stairs, wound checks, or remembering instructions. A second set of ears helps.
02
How to plan home safety
Think about loose rugs, bathroom setup, stairs, lighting, pets, walking aids, shower safety, and where you will sleep the first few nights.
03
When to call the office
Call for worsening wound redness, drainage, fever, severe swelling, a fall, medication confusion, or symptoms that do not match your instructions.
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When not to wait
Chest pain, shortness of breath, fainting, stroke-like symptoms, major deformity, or dangerous symptoms need emergency care.
Helpful to bring
X-rays, MRI, CT scans, or reports if you already have them
Where the pain starts, where it travels, and what it stops you from doing
Prior injections, therapy, medications, braces, or operations
Your goals for work, walking, golf, hiking, sports, travel, and recovery
Make the visit count
Bring the story, not just the scan.
Imaging helps, but the story matters too: what changed, what you tried, what failed, and what life you want back. This is especially important for revision opinions, prior surgery, and neighbor island travel.
Recovery preview
Prepare for BMAC or PRP aftercare
Orthobiologic aftercare should explain activity changes, response tracking, realistic expectations, and follow-up.
Injection-day guidance
Activity modification
Response tracking
Patient questions
Questions I hear in the office.
Which injection is best?
There is no universal best injection. The right option depends on diagnosis, imaging, prior treatments, health history, and goals.
Can injections delay surgery?
Sometimes they can help manage symptoms, but timing depends on severity, function, and whether surgery is already the more realistic conversation.
Can I get an injection before joint replacement?
Injection timing before surgery can matter. Ask before receiving injections near a possible surgery date.
Mahalo
You do not have to figure this out alone.
If pain, injury, arthritis, or an old implant is keeping you from life, bring your questions. Dr. Morton and the team will help you understand the problem and the next step.
Written for patients by the practice
Orthopedic guidance should be clear enough to help you make a real decision.
Dr. Paul Norio Morton created Joint Replacement Hawaii to help patients understand hip pain, knee pain, arthritis, sports injuries, robotic joint replacement, revision surgery, injections, and recovery before they come in for a visit.
