Two hundred and forty-seven post-menopausal women (146 with data at final follow-up) received a subcutaneous injection every 6 months and a pill weekly. These treatments were randomized as follows: Group one received denosumab injections and a placebo pill, Group two received alendronate and a placebo injection and Group three received a placebo injection and pill. The purpose of this trial was to compare the effects of these interventions on cortical bone porosity and trabecular bone/total volume. Results indicated that denosumab was effective in decreasing porosity in cortical bone at 6 and 12 months, and its effects were significantly greater than alendronate at 12 months. Trabecular bone/total volume was also similar between groups.