Study of the Key Techniques of Prevention and Treatment of Osteoporotic Refracture

Prior treatment

• Patients who have previously received external radiation or radiation therapy with bone implants;
• Participating in clinical trials of other drugs at present;

Other illness

• bone metabolic diseases except for osteoporosis eg. a. (Osteogenesis Imperfecta, Paget's disease, Osteomalacia), b. Cushing's syndrome, c.hyperprolactinemia;
• Active infection that requires systematic treatment;
• Patients with malignant tumors or bone metastases within 5 years, except tumors that are expected to be cured after treatment;
• Allergic to teriparatide and denosumab;

Lab values

• GFR\<30ml/min/1.73m2;
• Unexplained elevation of alkaline phosphatase;
• Uncontrolled comorbidities included heart failure above the New York cardiac Function Scale, glycosylated hemoglobin \&gt; 8.5%, and severe arrhythmias;

Other

• Having primary hyperparathyroidism or hypothyroidism;
• Had or have osteomyelitis of the jaw or necrosis of the jaw;
• Used intravenous bisphosphonate, fluoride, or strontium for osteoporosis within 2 years;
• Used teriparatide and denosumab for osteoporosis within 6 months;
• Used glucocorticoids (equivalent to \&gt;5 mg/day prednisone) for more than 10 days within 6 weeks;
• The time gap between the first time and the last time oral bisphosphonate for osteoporosis less than 1 year( if used within one year, but the cumulative use is ≤ 1 month, the subject can be enrolled) ;
• Have hypocalcemia and hypercalcemia;
• A serious deficiency of vitamin D (25OHD \&lt;10ng/mL);
• Planned pregnancy and lactation at present or during the study period;
• subjects do not suitable for this study

• New brittle hip fractures;
• New brittle vertebral fractures;
• New other site fractures and/or total hip or neck of femur or L1-L4 T-value \&lt; -1.0;
• Men or postmenopausal women;
• Age 45-90 years old;
• Ability to move autonomously