@jacjac
I am a 71 year old male. I was diagnosed with Osteoporosis. I fractured a vertebrae in 2023. I was approved for Evenity and took it for a year. No side effects and a 35% improvement in bone density.
I’m now on Prolia with no side effects. I know the hesitation with Prolia, per comments on this site and my own research. However, I decided to trust my Rheumatologist, who has been treating Osteoporosis for many years and has had patients on Prolia for over 15 years with no problems. I know that every case can differ and there are no guarantees. Michael Lavecot, on this discussion group, has a very good YouTube video on this as well. Thank you, Michael for all of your research.
I’m on an Aetna Medicare PPO plan. The Evenity injections were 100% covered, as are the Prolia injections. I hope this is helpful and I wish you all the best with your treatment.

@jacjac
evenity isn't FDA approved for men. There is off-label use, so your husband could get Evenity if he can find a agile physician. There is a study of starting Evenity three months after the Prolia injection, with a return to Prolia. Risedronate isn't considered strong enough to combat Prolia rebound, so a curious choice. And, probably, a save that your husband refused to tolerate side effects. I think I'd move to find an agreeable physician. Even though it is another curious choice since Evenity basically builds the same type of bone.
The most usual choice after Prolia is Reclast infusion. It is the strongest bisphosphonate and avoids some of the oral and digestive side effects. He could use Zometa infusions. It is the same drug as Reclast, but in smaller doses and usually given more frequently. Maybe a second opinion from a different endocrinologist.
I have read that Prolia concurrently with Forteo yields better bone than either alone. If the helpful surgeon would order Forteo you might have an answer. https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.888208/full
The trouble with thin bone and revision surgery is the both the weakness in that bone and the failure of hardware to integrate with bone. Forteo is the one medication known to increase that integration and to increase the fixation strength of the screws.

@jacjac the physician who orders the medication for your husband will need to perform a prior authorization request. They fill out the extenuating circumstances and submit it electronically. That should solve the concern I’m also male 73 on Alendronate for osteoporosis. Never had any issues.