In patients with secondary osteoporosis due to primary hyperparathyroidism, should parathyroidectomy be recommended in the setting of recent prior bisphosphonate use?

I would recommend parathyroid surgery in a person with confirmed primary hyperparathyroidism and osteoporosis as the bone density will increase in most patients after surgery. Many of the patients with osteoporosis may have received bisphosphonates. In rare situations, a patient may have received a bisphosphonate (like zoledronic acid) for clinically significant hypercalcemia prior to the surgery. Both groups of patients will benefit from surgery. In these patients, it is important to ensure ade...