For older adults over 70 with knee arthritis, taking a daily hyaluronic acid pill and doing leg exercises didn’t make their knee pain or stiffness any better than taking a sugar pill over a year.

Whether oral hyaluronic acid (200 mg/day) combined with daily quadriceps exercise improves symptoms in adults over 70 with moderate knee osteoarthritis compared to placebo over 12 months.

Whether the combination of hyaluronic acid and exercise has a synergistic, additive, or independent effect on symptom improvement compared to either component alone or placebo.

Whether real-world use of oral hyaluronic acid (200 mg/day) with daily quadriceps exercise is associated with symptom trajectories in older adults with moderate knee osteoarthritis over 12 months.

Whether prior use of oral hyaluronic acid (200 mg/day) with daily quadriceps exercise is less common among older adults with persistent moderate knee osteoarthritis symptoms after 12 months compared to those with improvement.

Whether adults over 70 with moderate knee osteoarthritis who report using hyaluronic acid and daily quadriceps exercise report different symptom levels than non-users at a single time point.