Nathanael Heckmann, MD

Dr. Nathanael Heckmann is an Associate Professor of Orthopaedic Surgery and a Clinical Scholar at the Keck School of Medicine of USC, where he also serves as Director of Arthroplasty Research in the Department of Orthopaedic Surgery.

His surgical practice focuses on treating degenerative diseases of the hip and knee, such as osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Dr. Heckmann performs a range of advanced procedures, including minimally invasive total hip and knee replacement, partial knee replacement, surgery to fix infected and failed hip and knee replacements, and robotic-assisted and computer-navigated arthroplasty.

Dr. Heckmann’s research focuses on clinical outcomes following hip and knee arthroplasty. His specific areas of inquiry include the diagnosis, treatment, and management of infected hip and knee replacements; perioperative patient optimization, including preoperative risk stratification and postoperative risk mitigation strategies; and exploring the relationship between the human gut microbiome and surgical outcomes.

He holds leadership positions in the American Academy of Orthopaedic Surgeons, the American Association of Hip and Knee Surgeons, and the Western Orthopaedic Association. He is also a member of The Hip Society and The Knee Society. Dr. Heckmann has authored 18 textbook chapters and over 240 peer-reviewed publications. His research has been presented over 350 times at national and international conferences.

• Super Doctors: Rising Star, 2021
   – 2025
• Pasadena Magazine: Top Doctor, 2021
   – 2025
• 2021
   -: Southern California Top Doctor & Rising Star, 2021
   – 2025
• Los Angeles Magazine: Top Doctor, 2021
   – 2025
• Western Orthopaedic Association: Young Investigator Award, 2023
   – 2025

• The Knee Society member (9/12/2024)

• Operative care rates of lateral compression type 1 pelvic fractures increased from 2003 to 2018. Eur J Orthop Surg Traumatol. 2026 Aug 01; 36(1).. View in PubMed
• Precision and Accuracy of Polyethylene Thickness in Total Knee Arthroplasty: A Comparison of Conventional Measured Resection and Robotic-Assisted Techniques. Arthroplast Today. 2026 Aug; 40:102097.. View in PubMed
• Perioperative Dexamethasone Is Associated With a Reduced Risk of Periprosthetic Joint Infection Following Aseptic Revision Total Hip and Knee Arthroplasty. Arthroplast Today. 2026 Aug; 40:102100.. View in PubMed
• Predictive Factors for Manipulations Under Anesthesia After Total Knee Arthroplasty: An Analysis of 15,139 Cases. J Am Acad Orthop Surg. 2026 Jul 23.. View in PubMed
• A Comparative Analysis of Lower Extremity Deformity Correction: Two-dimensional versus Three-dimensional Computed Tomography. J Knee Surg. 2026 Jul 16.. View in PubMed
• Dexamethasone is Associated with a Dose-Dependent Reduction in Venous Thromboembolic Complications following Total Knee and Hip Arthroplasty. J Arthroplasty. 2026 Jul 16.. View in PubMed
• Inflammatory Bowel Disease and Periprosthetic Joint Infection Following Total Joint Arthroplasty: Crohn’s Disease and Ulcerative Colitis Associated With Varying Risk. Arthroplast Today. 2026 Aug; 40:102077.. View in PubMed
• Risk of Total Hip Arthroplasty After Sacroiliac Joint Fusion Surgery: A Nationwide Study. Global Spine J. 2026 Jul 02; 21925682261463491.. View in PubMed
• Complication and Reoperation Rates of Post-Distal Femoral Osteotomy Total Knee Arthroplasty versus Primary Total Knee Arthroplasty: Matched Cohorts from a Nationwide Database. J Arthroplasty. 2026 Jun 29.. View in PubMed
• Reassessing Total Joint Arthroplasty Case Volumes in the United States: Accounting for Ultralow-Volume Surgeons. J Arthroplasty. 2026 Jun 27.. View in PubMed
• Stacked-Cone Constructs for Extensive Tibial and/or Femoral Bone Loss in Complex Primary and Revision TKA: A Multicenter Analysis of 84 Cases. J Bone Joint Surg Am. 2026 Jun 26.. View in PubMed
• The Efficacy and Safety of Tranexamic Acid in Revision Total Knee and Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. Arthroplast Today. 2026 Aug; 40:102054.. View in PubMed
• Neutrophil-Lymphocyte Ratio Trajectories Predict Mortality and Medical Complications in Hip Fracture Patients Undergoing Hemiarthroplasty. J Arthroplasty. 2026 Jun 19.. View in PubMed
• Transfusions Are Associated With an Elevated Risk of Venous Thromboembolism and Periprosthetic Joint Infection Following Revision Total Knee Arthroplasty. J Arthroplasty. 2026 Jun 17.. View in PubMed
• The John Charnley Award: A Randomized Controlled Trial of Dual Mobility and Single Bearings for Patients at High Risk of Dislocation Following Primary Total Hip Arthroplasty. J Arthroplasty. 2026 Jun 15.. View in PubMed
• A Concise Update on Decision-Making and Optimal Techniques in Revision Total Hip Arthroplasty. J Arthroplasty. 2026 Jun 04.. View in PubMed
• Emerging Concepts in Periprosthetic Joint Infection Research: RNA, DNA, and Protein Sequencing Tools for the Characterization and Diagnosis of Periprosthetic Joint Infection. J Arthroplasty. 2026 May 14.. View in PubMed
• Perioperative Dexamethasone in Periprosthetic Joint Infection Surgery: Diabetes-Stratified Results From a Propensity Score-Matched Retrospective Cohort Study. Anesth Analg. 2026 Apr 27.. View in PubMed
• Age-Related Microbiologic Trends in Periprosthetic Joint Infection of the Knee: Increased Rates of Atypical Pathogens With Increasing Age. Arthroplast Today. 2026 Jun; 39:102021.. View in PubMed
• Technology Assistance Mitigates the Volume-Dependent Risk of Hip Dislocation Following Total Hip Arthroplasty. J Bone Joint Surg Am. 2026 Apr 20.. View in PubMed
• Delayed Administration of Apixaban and Rivaroxaban is Associated with Reduced Rates of Postoperative Bleeding Without Increasing Thromboembolic Risk Following Elective Total Hip Arthroplasty. J Arthroplasty. 2026 Apr 17.. View in PubMed
• Restoring the coronal plane alignment of the knee (CPAK) phenotype does not consistently improve patient-reported outcomes after primary total knee arthroplasty: A systematic review. Knee Surg Sports Traumatol Arthrosc. 2026 Apr 16.. View in PubMed
• Increased Opioid Consumption Following Total Knee Arthroplasty Is Associated With an Increased Risk of Manipulation Under Anesthesia. J Arthroplasty. 2026 07; 41(S1):S357-S362.e2.. View in PubMed
• Defining the relationship between the hip, pelvis, and lumbar spine. N Am Spine Soc J. 2026 Jun; 26:100883.. View in PubMed
• Hip Spine Syndrome: Management of Patients With Concurrent Hip and Spine Degenerative Pathologies: Erratum. J Am Acad Orthop Surg. 2026 Apr 01; 34(7):e958.. View in PubMed
• Assessing the diagnostic accuracy of synovial fluid send-out laboratory panels for suspected knee periprosthetic joint infection. Bone Joint J. 2026 Apr 01; 108.. View in PubMed
• Reply to Letter to the Editor on “A ‘1.5-Stage’ Spacer Construct Using Revision Components for the Management of Periprosthetic Joint Infections of the Knee”. J Arthroplasty. 2026 Apr; 41(4):e29-e31.. View in PubMed
• Total Lymphocyte Count Fails as a Predictor of Acute Periprosthetic Joint Infection for Total Hip or Knee Arthroplasty. J Arthroplasty. 2026 07; 41(S1):S342-S349.e2.. View in PubMed
• An Increase in the Treatment of High-Risk Total Joint Arthroplasty Patients Who Have Medicare at Teaching Hospitals. J Arthroplasty. 2026 Mar 26.. View in PubMed
• Bone Morphogenetic Protein Augmentation of Large Acetabular Defects in Revision Total Hip Arthroplasty: A Viable Option for Massive Bone Loss. Arthroplast Today. 2026 Jun; 39:101998.. View in PubMed
• Aspirin Is Associated With Improved Thromboprophylaxis Versus Low-Molecular-Weight Heparin Following Revision Knee Arthroplasty for Periprosthetic Joint Infection. J Arthroplasty. 2026 Mar 03.. View in PubMed
• The Limited Utility of Synovial C-Reactive Protein in the Diagnosis of Knee and Hip Periprosthetic Joint Infection: Proposed New Diagnostic Cutoffs. J Arthroplasty. 2026 Feb 21.. View in PubMed
• Complications and Reoperation Rates of Total Knee Arthroplasty After High Tibial Osteotomy: A Matched Cohort Analysis From a Nationwide Database. Arthroplast Today. 2026 Feb; 37:101941.. View in PubMed
• Postoperative Clopidogrel Thromboprophylaxis in TJA: Increased Risk of Transfusion but Similar Venous Thromboembolic Risk Compared with Aspirin. J Bone Joint Surg Am. 2026 May 20; 108(10):729-737.. View in PubMed
• Association of Perioperative Dexamethasone With Postoperative Complications After Primary Total Joint Arthroplasty: An Instrumental Variable Analysis. Anesth Analg. 2026 Aug 01; 143(2):364-372.. View in PubMed
• GLP-1 receptor agonist utilization is associated with a low risk of Anesthesia-related complications prior to total joint arthroplasty. Eur J Orthop Surg Traumatol. 2025 Dec 06; 36(1):37.. View in PubMed
• Dual-Antiplatelet Therapy Is Not Associated With Greater Odds of Postoperative Bleeding Following Elective Total Joint Arthroplasty. J Am Acad Orthop Surg. 2026 May 15; 34(10):e1480-e1487.. View in PubMed
• Delayed Administration of Apixaban, but Not Rivaroxaban, Reduces Transfusion Risk Without Increasing Thromboembolic Rates Following Revision Total Hip Arthroplasty. J Arthroplasty. 2025 Nov 27.. View in PubMed
• Preoperative Hemoglobin as a Continuous Predictor of Postoperative Complications Following Elective Total Hip Arthroplasty. J Arthroplasty. 2026 08; 41(8):2424-2431.e6.. View in PubMed
• Response to the Letter to the Editor Commenting on “Low-Level Evidence Used to Substantiate Insurance Coverage Policies for Knee and Hip Arthroplasty”. J Arthroplasty. 2025 Nov; 40(11):e77-e78.. View in PubMed
• 2025 ICM: Risk Factors for Surgical Site Infection (SSI)/Periprosthetic Joint Infection (PJI). J Arthroplasty. 2025 Dec; 41(1S1):S6-S18.. View in PubMed
• 2025 ICM: Anemia, Blood-Saving, and Thromboprophylaxis. J Arthroplasty. 2025 Dec; 41(1S1):S19-S29.. View in PubMed
• 2025 ICM: Sample Collection and Agent Identification. J Arthroplasty. 2025 Dec; 41(1S1):S157-S163.. View in PubMed
• Emerging Concepts in Periprosthetic Joint Infection Research: Infection Recurrence and Microbe Persistence. J Arthroplasty. 2026 06; 41(6):1813-1821.. View in PubMed
• Spin and reporting bias in the use of platelet-rich plasma for the treatment of knee osteoarthritis. Eur J Orthop Surg Traumatol. 2025 Aug 12; 35(1):348.. View in PubMed
• Novel Technologies in Periprosthetic Joint Infection: Emerging Diagnostics. J Arthroplasty. 2026 02; 41(2):551-559.. View in PubMed
• Erratum to ‘The Limited Utility of Hemoglobin A1c as a Predictor for Periprosthetic Joint Infection Following Total Joint Arthroplasty: A Continuous Variable Analysis’ [The Journal of Arthroplasty 40 (2025) 1836-1844]. J Arthroplasty. 2025 Oct; 40(10):2771.. View in PubMed
• Hip Spine Syndrome: Management of Patients With Concurrent Hip and Spine Degenerative Pathologies. J Am Acad Orthop Surg. 2026 Feb 01; 34(3):e315-e323.. View in PubMed
• Total Hip Arthroplasty Among Superobese Patients: Proceed With Caution. Arthroplast Today. 2025 Aug; 34:101770.. View in PubMed
• Neutrophil-Lymphocyte Ratios and Optimal Surgical Timing for Hemiarthroplasty for Femoral Neck Fracture. J Am Acad Orthop Surg. 2026 Feb 01; 34(3):e447-e456.. View in PubMed
• Novel Technologies in Periprosthetic Joint Infections: Emerging Therapeutics. J Arthroplasty. 2026 02; 41(2):560-568.. View in PubMed
• The Management of Chronic Periprosthetic Joint Infection: No Longer Is It “One Size Fits All”. J Arthroplasty. 2025 09; 40(S1):S84-S91.. View in PubMed
• Estrogen Replacement Therapy Decreases Associated Risk of Postoperative Venous Thromboemboli and Medical Complications After Total Joint Arthroplasty. J Arthroplasty. 2025 11; 40(11):2995-2999.e1.. View in PubMed
• Medicare Reimbursement for Primary Hip and Knee Arthroplasty Is Disproportionately Decreasing Relative to Other High-Volume Inpatient Procedures: Leader of the Pack. J Arthroplasty. 2025 Sep; 40(9S1):S105-S109.. View in PubMed
• Low-Level Evidence Used to Substantiate Insurance Coverage Policies for Knee and Hip Arthroplasty. J Arthroplasty. 2025 Sep; 40(9S1):S142-S151.. View in PubMed
• Rivaroxaban Utilization Without Perioperative Tranexamic Acid Is Associated With an Increased Risk of Bleeding Complications Following Total Joint Arthroplasty. J Arthroplasty. 2025 10; 40(10):2586-2592.e3.. View in PubMed
• Increased Incidence of Spin and Reporting Bias on the Use of Hyaluronic Acid for the Treatment of Knee Osteoarthritis: An Evaluation of Systematic Reviews and Meta-Analyses. J Arthroplasty. 2025 Sep; 40(9S1):S581-S587.. View in PubMed
• Effect of BMI on the risk of postoperative complications following total hip arthroplasty. Bone Joint J. 2025 May 01; 107.. View in PubMed
• Emerging Concepts in Periprosthetic Joint Infection Research: Intracellular Organisms. J Arthroplasty. 2026 01; 41(1):176-185.. View in PubMed
• The Rise of Medicare Advantage is Impacting the Fidelity of Traditional Medicare Claims Data: Implications for Reporting of Long-Term Total Knee Arthroplasty Survivorship. J Bone Joint Surg Am. 2025 Apr 25; 107(12):1371-1376.. View in PubMed
• Medicare Reimbursement for Primary and Revision Total Hip and Knee Arthroplasty: An Updated Analysis From 2000 to 2024. J Arthroplasty. 2025 Sep; 40(9S1):S100-S104.e1.. View in PubMed
• Response to Letters to the Editor: Is Dexamethasone Administration During Total Hip and Knee Arthroplasty Safe in Diabetic Patients? J Am Acad Orthop Surg. 2025 Jun 01; 33(11):e614. Kebaish KJ, Wang J . View in PubMed
• Dexamethasone Is Associated With Lower Rates of Pulmonary Complications Following Cemented Femoral Fixation During Primary Total Hip Arthroplasty. J Arthroplasty. 2025 Aug; 40(8S1):S159-S165.e1.. View in PubMed
• Stacked Cone Constructs for the Treatment of Extensive Tibial Bone Loss in Revision Total Knee Arthroplasty: A Series of 22 Patients. J Bone Joint Surg Am. 2025 Mar 24; 107(12):1342-1351.. View in PubMed
• Efficacy of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty system in restoring limb length and offset. Arch Orthop Trauma Surg. 2025 Mar 05; 145(1):175.. View in PubMed
• Preoperative Anemia as a Predictor of Periprosthetic Joint Infection Following Total Knee Arthroplasty: A Continuous Variable Analysis. J Arthroplasty. 2025 Jul; 40(7S1):S169-S175.e5.. View in PubMed
• Albumin as a Predictor of Periprosthetic Joint Infection Following Total Joint Arthroplasty: Identifying a New Data-Driven Threshold Utilizing a Continuous Variable Analysis. J Arthroplasty. 2025 08; 40(8):2117-2125.e4.. View in PubMed
• A “1.5-Stage” Spacer Construct Using Revision Components for the Management of Periprosthetic Joint Infection of the Knee. J Arthroplasty. 2025 Aug; 40(8):1952-1960.. View in PubMed
• The Limited Utility of Hemoglobin A1c as a Predictor for Periprosthetic Joint Infection Following Total Joint Arthroplasty: A Continuous Variable Analysis. J Arthroplasty. 2025 07; 40(7):1836-1844.e5.. View in PubMed
• The Impact of Contemporary Glucagon-like Peptide-1 Receptor Agonists on the Onset, Severity, and Conversion to Arthroplasty in Hip and Knee Osteoarthritis. Orthop J Sports Med. 2025 Jan; 13(1):23259671241297157.. View in PubMed
• Emerging Concepts in Periprosthetic Joint Infection Research: The Human Microbiome. J Arthroplasty. 2025 07; 40(7):1821-1826.. View in PubMed
• Pain Management in Total Hip and Knee Arthroplasty: Evidence-Based and Controversial Practices in 2024. Instr Course Lect. 2025; 74:301-310.. View in PubMed
• Characterizing the Rotational Profile of the Distal Femur: A Roadmap for Distal Femoral Replacement Surgery. J Am Acad Orthop Surg. 2025 Apr 01; 33(7):e401-e409.. View in PubMed
• Risk Factors for Venous Thromboembolism Following Total Knee Arthroplasty: An Analysis of 3,052 Pulmonary Emboli. J Am Acad Orthop Surg. 2025 Apr 01; 33(7):e380-e390.. View in PubMed
• Medicaid Insurance Is Associated With Increased Readmissions and Mortality After Surgery for Periprosthetic Joint Infection. J Am Acad Orthop Surg. 2025 Apr 01; 33(7):e391-e400.. View in PubMed
• Reply to the Letter to the Editor: Why Did the “Five-Year Incidence of Progression to Osteoarthritis and Total Joint Arthroplasty in Patients Prescribed Glucagon-Like Peptide 1 Receptor Agonists” Diff . View in PubMed
• Endocrinologic Abnormalities Observed Among Total Joint Arthroplasty Patients Using “Artri King” and Related Over-the-Counter Supplements: A Cautionary Tale from a Safety Net Hospital. J Clin Med. 2024 Nov 28; 13(23).. View in PubMed
• Is Aspirin Safe for Thromboprophylaxis After Surgery for Lower Extremity Neoplastic Pathologic Fractures? J Surg Oncol. 2025 Apr; 131(5):942-954. Chen MS, Gettleman BS, Liu KC, Richardson MK, Talehaki . View in PubMed
• Complete Blood Cell Count-Based Ratios Identify Total Joint Arthroplasty Patients Likely to Benefit from Perioperative Dexamethasone. J Bone Joint Surg Am. 2025 Jan 15; 107(2):163-173.. View in PubMed
• Safety and Efficacy of Aspirin Compared to Enoxaparin Following Total Hip and Total Knee Arthroplasty Among Patients Who Have a History of Venous Thromboembolic Disease. J Arthroplasty. 2025 Jun; 40(6):1484-1491.e4.. View in PubMed
• Alarmingly High Rates of Deep Vein Thrombosis and Pulmonary Embolism Following Closed Reduction for Dislocated Total Hip Arthroplasty. J Arthroplasty. 2025 Jun; 40(6):1629-1635.e4.. View in PubMed
• Tranexamic Acid Is Safe in Arthroplasty Patients Who Have a History of Venous Thromboembolism: An Analysis Accounting for Surgeon Selection Bias. J Arthroplasty. 2025 Jun; 40(6):1492-1499.e1.. View in PubMed
• Are Activity Restrictions Necessary After Total Hip Arthroplasty: A Systematic Review. Arthroplast Today. 2024 Dec; 30:101576.. View in PubMed
• Evaluating the References of Insurance Policies for Computer-Assisted Navigation in Total Knee Arthroplasty Compared With the American Academy of Orthopaedic Surgeons Clinical Practice Guideline. Orthopedics. 2025 Jan-Feb; 48(1):8-11.. View in PubMed
• Low-Volume Surgeons Operating at High-Volume Hospitals Have Low Rates of Periprosthetic Joint Infection After Hip and Knee Arthroplasty. J Arthroplasty. 2025 05; 40(5):1317-1325.e4.. View in PubMed
• Dual-Mobility Articulations in Primary Total Hip Arthroplasty: Mid-Term Outcomes From the American Joint Replacement Registry. J Arthroplasty. 2025 05; 40(5):1252-1257.e3.. View in PubMed
• Perioperative Tranexamic Acid Should Be Considered for Total Joint Arthroplasty Patients Receiving Apixaban for Thromboprophylaxis. Arthroplast Today. 2024 Dec; 30:101548.. View in PubMed
• The Relationship Between Surgeon Volume and Major Surgical Complications After Total Shoulder Arthroplasty: An Evaluation of 3177 US Orthopedic Surgeons. Orthopedics. 2025 Jan-Feb; 48(1):e15-e21.. View in PubMed
• Spinal Anesthesia in Total Hip Arthroplasty is Associated With Improved Outcomes in the American Joint Replacement Registry Population. Arthroplast Today. 2024 Dec; 30:101566.. View in PubMed
• Is Dexamethasone Administration During Total Hip and Knee Arthroplasty Safe in Diabetic Patients? J Am Acad Orthop Surg. 2025 Mar 01; 33(5):242-252. Kebaish KJ, Wang JC, Piple AS, Wier J, Liu KC, Chri . View in PubMed
• Medicare Advantage Is Associated With Higher Mortality After Antibiotic Spacer Placement for Periprosthetic Joint Infection. J Arthroplasty. 2025 04; 40(4):854-859.e6.. View in PubMed
• Body Mass Index and the Risk of Postoperative Complications After Total Knee Arthroplasty. J Am Acad Orthop Surg. 2025 Jan 01; 33(1):e36-e45.. View in PubMed
• The change in lumbar lordosis from the standing to the lateral position: implications for lateral interbody fusion. Eur Spine J. 2025 01; 34(1):148-155.. View in PubMed
• Identifying a Reliable Intra-articular Landmark to Avoid Vascular Injury During Transacetabular Screw Fixation: A 3D Computed Tomography Study. J Am Acad Orthop Surg. 2025 Feb 01; 33(3):e172-e180.. View in PubMed
• International medical graduates (IMGs) matching into US orthopaedic surgery residency: a fifteen year analysis of trends in applications and geographical distribution. Int Orthop. 2024 11; 48(11):2775-2784.. View in PubMed
• Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty: A Primer for Clinical Practice. JBJS Rev. 2024 Sep 01; 12(9).. View in PubMed
• Reply to the Letter to the Editor: Risk Factors Associated with Thromboembolic Complications Following Total Hip Arthroplasty: An Analysis of 1,129 Pulmonary Emboli. J Am Acad Orthop Surg. 2025 Feb 15; 33(4):e257-e258.. View in PubMed
• Perioperative Dexamethasone in Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized, Placebo-Controlled Trials. Anesth Analg. 2024 09 01; 139(3):479-489.. View in PubMed
• Cemented Constrained Liners Used as an Articulating Hip Spacer for the Treatment of Chronic Prosthetic Joint Infection. Arthroplast Today. 2024 Oct; 29:101422.. View in PubMed
• Postoperative outcomes and trends in computer-navigated and robotic-assisted total hip arthroplasty. Hip Int. 2024 Sep; 34(5):569-577.. View in PubMed

• Lieberman, Jay
• Demetriades, Demetrios
• Oakes, Daniel
• Patterson, Joseph
• Derogatis, Michael
• Wang, Jeffrey