SMAD5 and osteonecrosis: There are few clinical trials targeting miR-23a in bone disease, and only some studies have shown that icariin promotes osteogenic differentiation of bone marrow stem cells and improves osteonecrosis of the femoral head by reducing miR-23a-3p levels and regulating BMP-2/Smad5/Runx2 and WNT/β-catenin pathways (139).