This chapter presents the case scenario of seventy‐year‐old ambulatory postmenopausal Caucasian female who lives independently slips and falls in the bathtub. Hip fractures are the most severe type of fragility fracture as they require hospital admission and are associated with significant morbidity and mortality. The presence of a fragility fracture is a major risk factor for osteoporosis and is an important indicator for osteoporosis diagnosis and treatment. Opinion among orthopedic surgeons is divergent on which pharmacologic agents are best to reduce the relative risk of hip fractures in postmenopausal women who present with low bone mineral density or a fragility fracture. A number of different pharmacologic agents are available for the treatment of osteoporosis. The fracture clinical trial of denosumab reported a relative risk reduction of hip fracture with denosumab of 40% and vertebral of 68%. The chapter also provides recommendations for implementing evidence‐based practice in the clinical setting.