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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.
Revision hip and knee clinic
A second-opinion friendly clinic for painful hip and knee replacements.
If your hip or knee replacement hurts, feels unstable, is stiff, or has been called loose, infected, worn, or failed, I want to understand the story before recommending another operation.
Online booking in about a minuteHMSA, Medicare & other major plansHonolulu · West Oahu · Hilo · KonaTelehealth for neighbor islands
Board-certifiedFellowship-trainedFAAOS / FAAHKSRobotic hip & kneeRevision expertiseHawaii roots
How the visit works
You should leave with a clearer plan than when you arrived.
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Look at the source
Your exam and imaging help separate arthritis, injury, implant problems, referred pain, and other causes that can feel similar.
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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.
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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
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What are you noticing?
Swelling
Instability or giving way
Stiffness or limited motion
Catching or locking
Grinding
Difficulty bearing weight
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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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Start with the reason
Pain alone is not a diagnosis. Revision planning depends on why the implant is not working, and sometimes the pain is not coming from the implant at all.
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Bring the history
Operative reports, implant labels, X-rays, CT scans, labs, aspiration results, and prior recommendations can change the discussion.
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Know when surgery helps
Some painful implants need revision surgery. Others need more testing or treatment of a different source. The point of the visit is to make that distinction clearer.
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The first visit is a workup, not a promise of surgery
Many patients need explanation more than they need an immediate operation. We start by identifying what is known, what is missing, and what testing could change the recommendation.
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What to bring if you can
Bring operative reports, implant cards, X-rays, CT or MRI reports, infection labs, aspiration results, injection history, and a written timeline from the first surgery to now.
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For caregivers and family
Revision decisions are stressful. A spouse, adult child, or trusted friend can help track the history, ask practical questions, and understand what recovery would require.
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.
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What may make us wait
- The pain source is not clear yet
- More records or labs are needed
- Another non-implant problem may explain the symptoms
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What may make revision reasonable
- Clear loosening, instability, wear, fracture, or failed implant problem
- Infection workup has been addressed
- The expected benefit is worth the complexity
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What may mean more tests
- ESR, CRP, aspiration, or culture questions
- CT scan for bone loss or implant position
- Old operative report or implant labels are missing
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What changes recovery planning
- Bone loss, infection concern, or complex reconstruction
- Caregiver support and fall risk
- Longer restrictions than first-time replacement
Revision second opinion
Before another operation, we need to know why the implant hurts.
A painful hip or knee replacement can come from the implant, the bone, infection, instability, stiffness, the spine, or soft tissues. I want the story and records before we decide what another surgery can or cannot fix.
Think about 01
Bring the old records
Operative reports, implant labels, X-rays, labs, aspiration results, and a symptom timeline help us understand what changed.
Think about 02
Look for the real cause
Loosening, infection, wear, instability, stiffness, fracture, and referred pain can feel similar to patients but need very different plans.
Think about 03
Match the plan to the problem
Revision surgery only makes sense when it is aimed at the problem we can identify. If pain comes from somewhere else, we need a different answer.
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.
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Revision workup
Painful implants need a reason. Records, labs, aspiration, CT, implant labels, and X-rays may all matter.
Infection rule-outLoosening and wear reviewBone loss planning
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Second opinion value
Another operation should not be chosen until the likely cause and realistic benefit are clear.
Records-first reviewRisk and benefit discussionAlternatives when surgery is not the answer
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
Painful implants need patience and records.
When a replacement hurts, the first job is to understand why. Old records, imaging, labs, and the patient's story can change the entire plan.
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Revision hip and knee evaluation
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Painful implant second opinions
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Old operative report and implant review
You may be ready to schedule if
Pain after hip or knee replacement
Instability, dislocation, stiffness, or swelling
Concern for loosening, wear, infection, or fracture
Considering another operation
You are not sure whether revision surgery is truly necessary
You need help gathering or understanding old records
Your family wants to understand risks, recovery, and alternatives
Why patients choose this practice
Complex revision hip and knee replacement is a major practice focus
Bring your old records so we can understand what changed
Second-opinion friendly visits for painful, stiff, unstable, or failed implants
Old operative notes, implant records, labs, and imaging can change the plan
Infection, loosening, instability, stiffness, wear, fracture, and spine sources are considered
A second-opinion visit can be useful even before you decide on revision surgery
Caregiver, transportation, stairs, medications, and home safety are part of the plan
Older patients are encouraged to bring a spouse, adult child, or trusted helper
Recovery instructions are written for the patient and the person helping at home
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.
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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.
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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 revision recovery
Revision patients often need more records, more planning, and more caregiver support than first-time replacement patients.
Records-first planning
Complex restrictions
Warning signs
Patient questions
Questions I hear in the office.
Is it okay to come only for a second opinion?
Yes. Many revision patients come because they want the decision explained before committing to another surgery.
Can you review both hip and knee concerns?
Yes, but records and current imaging are especially important when more than one joint is involved.
What if I do not know what implant I have?
Bring what you have. We can help identify what records would be useful to request.
Can a painful replacement be caused by the back or soft tissues?
Yes. Spine, tendon, nerve, muscle, fracture, infection, loosening, and instability can overlap. That is why diagnosis comes first.
Is a second opinion insulting to my first surgeon?
No. Revision decisions are high-stakes, and a careful second opinion is a normal way to make sure the plan makes sense.
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.
