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

Inclusion Criteria:

1. New brittle hip fractures;

2. New brittle vertebral fractures;

3. New other site fractures and/or total hip or neck of femur or L1-L4 T-value < -1.0;

4. Men or postmenopausal women;

5. Age 45-90 years old;

6. Ability to move autonomously

Exclusion Criteria:

1. bone metabolic diseases except for osteoporosis eg. a. (Osteogenesis Imperfecta,Paget's disease, Osteomalacia), b. Cushing's syndrome, c.hyperprolactinemia;

2. Having primary hyperparathyroidism or hypothyroidism;

3. Had or have osteomyelitis of the jaw or necrosis of the jaw;

4. GFR<30ml/min/1.73m2;

5. Active infection that requires systematic treatment;

6. Used intravenous bisphosphonate, fluoride, or strontium for osteoporosis within 2years;

7. Used teriparatide and denosumab for osteoporosis within 6 months;

8. Used glucocorticoids (equivalent to &gt;5 mg/day prednisone) for more than 10 dayswithin 6 weeks;

9. The time gap between the first time and the last time oral bisphosphonate forosteoporosis less than 1 year( if used within one year, but the cumulative use is ≤ 1 month, the subject can be enrolled) ;

10. Patients with malignant tumors or bone metastases within 5 years, except tumors thatare expected to be cured after treatment;

11. Have hypocalcemia and hypercalcemia;

12. Unexplained elevation of alkaline phosphatase;

13. A serious deficiency of vitamin D (25OHD &lt;10ng/mL);

14. Patients who have previously received external radiation or radiation therapy withbone implants;

15. Uncontrolled comorbidities included heart failure above the New York cardiacFunction Scale, glycosylated hemoglobin &gt; 8.5%, and severe arrhythmias;

16. Planned pregnancy and lactation at present or during the study period;

17. Allergic to teriparatide and denosumab;

18. Participating in clinical trials of other drugs at present;

19. subjects do not suitable for this study