In this context, antiresorptive drugs like the monoclonal RANKL-antibody denosumab or intravenous bisphosphonates may be an effective and safe option to preserve the cortical and trabecular bone microarchitecture and to counteract progression of BME to osteonecrosis if surgical measures are not indicated9–11,26. The gene discussed is TNFSF11; the disease is osteonecrosis.