A 68-year-old postmenopausal woman presents to your office for follow-up regarding her osteoporosis management. She has been postmenopausal for 18 years and was diagnosed with osteoporosis two years ago. A vertebral compression fracture occurred one year ago, underscoring her high fracture risk. Her medical history is significant for well-controlled hypertension managed with amlodipine, and she has no known renal or hepatic disease. A recent DXA (dual-energy X-ray absorptiometry) scan revealed a T-score of -2.8 at the lumbar spine and -2.5 at the hip, indicating further decline in bone mineral density despite adequate calcium and vitamin D supplementation. On clinical evaluation, Mrs. Doe reports no new fractures or severe back pain. Laboratory tests show normal calcium levels (9.2 mg/dL), sufficient vitamin D status (30 ng/mL), and preserved renal function with an eGFR of 85 mL/min. You prescribed her alendronate. Which of the following is the primary mechanism of action of bisphosphonates in treating osteoporosis?
