Osteoporosis is a skeletal disorder characterised by compromised bone strength, predisposing to an increased risk of fracture. More than 40% of women and 14% of men over the age of 50 years will experience fractures related to osteoporosis. Globally, approximately 200 million people are at risk of sustaining an osteoporotic fracture each year. It is expected that osteoporosis will become epidemic in the years to come as a result of the increasing number of elderly people. At a tissue level, there is a decrease in the cancellous bone mineral density. There is also a decrease in the density of cortical bone, because of an increase in porosity, which can affect the holding capacity of screws. osteoporosis is reflected in a dramatic increase in the rate of failure of implant fixation. There are several possible explanations for this effect. There might be fewer mesenchymal stem cells in osteoporotic individuals, which have a lower proliferative response. This may explain the age-related decrease in the number of osteoblasts. Mesenchymal stem cells in post-menopausal women differ from those in the pre-menopausal by having a lower rate of growth and a deficiency in their ability to differentiate along the osteogenic lineage. Finally, bone cells from osteoporotic patients may have an impaired long-term response to mechanical stress.