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Hilo revision hip and knee opinions

Revision Hip and Knee Replacement in Hilo: painful implants and second opinions.

Hilo patients with pain after a hip or knee replacement often need more than a quick opinion. A useful revision visit starts with old records, new imaging, infection questions, implant details, and a careful explanation of what might be wrong before another operation is discussed.

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Board-certifiedFellowship-trainedFAAOS / FAAHKSRobotic hip & kneeRevision expertiseHawaii roots

How the visit works

You should leave with a clearer plan than when you arrived.

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.

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.

01

Hilo patients need a plan that works in real life

Hilo patients often come with a strong sense of local community and family support. Dr. Morton grew up in Hawaii, and the goal is to explain the orthopedic decision in a way that respects both the medical problem and the realities of Big Island care.

02

If you are helping a parent or spouse

If an older parent or spouse is coming from Hilo, bring the person who helps with rides, medications, stairs, groceries, and questions after the visit. That makes the plan safer and less confusing.

03

What changes a revision hip and knee replacement recommendation

The recommendation changes when labs, aspiration, X-rays, CT scans, implant records, and the symptom timeline point toward infection, loosening, instability, wear, stiffness, fracture, or pain coming from another source.

04

Planning around East Hawaii

East Hawaii patients should talk through imaging transfer, interisland timing, therapy access, airport days, and what symptoms should trigger a call before traveling.

05

What to bring so we can move faster

Bring X-rays, MRI reports, operative reports if there was prior surgery, medication lists, and a simple timeline of when the pain or instability changed.

06

Diagnosis before another operation

Revision planning depends on the reason the implant is not working: loosening, infection concern, instability, stiffness, wear, fracture, soft tissue problems, or pain from another source.

07

Bring the old records

Operative reports, implant labels, X-rays, CT scans, lab results, aspiration results, and a symptom timeline can make the visit more useful.

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

  • The pain source is not clear yet
  • More records or labs are needed
  • Another non-implant problem may explain the symptoms

02

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

03

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

04

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.

01

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

02

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.

01

Revision hip and knee evaluation

02

Painful implant second opinions

03

Old operative report and implant review

You may be ready to schedule if

A prior hip or knee replacement is painful, stiff, unstable, swollen, loose, or repeatedly dislocating
You need a second opinion with old operative reports, implant records, labs, imaging, or aspiration results
You live in Hilo or East Hawaii and want the visit to answer practical travel and recovery questions
You want a clear explanation before choosing surgery, injections, therapy, or more testing
A family member or caregiver will help you make the decision or recover afterward
Pain after hip or knee replacement
Instability, stiffness, swelling, or repeated dislocation
Concern for loosening, infection, wear, fracture, or implant failure
Need for a second opinion before revision

Why patients choose this practice

Board-certified and fellowship-trained orthopedic surgeon
Big Island-raised care for Oahu, Big Island, and neighbor island patients
Patient guides created from the Joint Replacement Hawaii education library
Revision hip and knee replacement is a major practice focus
East Hawaii planning with Big Island roots, imaging review, family support, and recovery logistics
Dr. Morton explains what would make him wait, order more tests, or recommend a procedure

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.

01

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.

04

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.

Why do revision opinions need so many old records?

Pain after replacement can come from loosening, infection, instability, wear, stiffness, fracture, or pain somewhere else. Old records help Dr. Morton understand what implant is in place and what changed over time.

What should Hilo patients send or bring before the visit?

Bring X-rays, MRI reports, operative reports if there was prior surgery, medication lists, and a simple timeline of when the pain or instability changed.

Should I bring someone with me?

If an older parent or spouse is coming from Hilo, bring the person who helps with rides, medications, stairs, groceries, and questions after the visit. That makes the plan safer and less confusing.

How does East Hawaii travel affect the plan?

East Hawaii patients should talk through imaging transfer, interisland timing, therapy access, airport days, and what symptoms should trigger a call before traveling.

Do painful implants always need revision?

No. The first goal is diagnosis. Some painful implants need surgery, while others need a different workup or treatment plan.

Can I come for a second opinion only?

Yes. Revision decisions are complex, and many patients want a focused second opinion before committing to another operation.

What records matter most?

Operative reports, implant records, imaging, lab results, aspiration results, and a clear symptom timeline are especially helpful.

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.

Recognition

Awards, focused training, and Hawaii-specific care planning help patients compare trust before they schedule.

US News High Performing in Hip and Knee Replacement
2025 Top Doctors
Best of West 2023
40 Under 40
First Hawaii orthopedic surgeon fellowship-trained in robotic joint replacement
ACGME-accredited fellowship training in hip and knee replacements
Minimally invasive, muscle-sparing approaches when appropriate
Concierge-style coordination for travel and neighbor island patients
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