Aim: Evaluate the clinical, functional, and radiological results in young patients with severe osteoarthritis (grade 3 and 4) of the knee joint who undergo knee joint distraction, with or without arthroscopic debridement and chondroplasty. Material and methods: The present investigation, which was both prospective and randomized controlled, was carried out in the orthopaedics department. A total of 140 patients who met the inclusion criteria were enrolled in the study and were then randomly assigned to two groups: Group A (70 patients) (KJD group), consisting of patients who underwent only KJD; and Group B (70 patients) (SCOPY + KJD group), consisting of patients who underwent both KJD and arthroscopic joint debridement and chondroplasty. The research comprised patients under the age of 55 who had grade 3 or 4 primary osteoarthritis of the knee joint according to the Kellegren and Lawrence classification. The clinical, functional, and radiological results were evaluatedusing the VAS score,WOMAC score, and radiographic JSW measurement, respectively before the operation, at the time of fixator removal (6 weeks after surgery), and at the 6th, 12th, 18th, and 24th month after surgery. A final comparison was conducted between the preoperative and 24-month results. Results: The mean VAS score was 8.2 ± 1.1 in Group A and 8.3 ± 1.0 in Group B (p = 0.78). At 6 weeks, the VAS score reduced to 6.5 ± 1.2 in Group A and 5.8 ± 1.3 in Group B, with a significant difference favoring Group B (p = 0.04). At 6 months, the scores were 5.2 ± 1.0 in Group A and 4.6 ± 1.1 in Group B (p = 0.03). By 12 months, the scores further improved to 4.0 ± 0.9 in Group A and 3.5 ± 1.0 in Group B (p = 0.05). At 18 months, the scores were 3.2 ± 0.8 in Group A and 2.9 ± 0.7 in Group B (p = 0.06). At the final follow-up at 24 months, the VAS scores were 3.0 ± 0.7 in Group A and 2.5 ± 0.6 in Group B, showing a significant difference in favor of Group B (p = 0.02).Functional outcomes assessed using the WOMAC score also showed significant improvements. Preoperatively, the WOMAC score was 78.5 ± 10.5 in Group A and 79.0 ± 10.2 in Group B (p = 0.67). At 6 weeks, the scores were 70.3 ± 9.8 in Group A and 68.5 ± 10.0 in Group B (p = 0.43). At 6 months, the scores further improved to 60.5 ± 8.6 in Group A and 58.0 ± 8.8 in Group B (p = 0.34). By 12 months, the scores were 55.2 ± 7.9 in Group A and 52.6 ± 8.0 in Group B (p = 0.31). At 18 months, the scores were 50.1 ± 7.2 in Group A and 47.5 ± 7.5 in Group B (p = 0.29). At the final follow-up at 24 months, the WOMAC scores were 48.0 ± 6.8 in Group A and 44.0 ± 6.5 in Group B, showing a significant difference in favor of Group B (p = 0.03). Conclusion : KJD in patients with osteoarthritis of knee(Kellegren Lawrence grade 3-4) aged less than 55 years results in improvement of clinical, functional and radiological parameters at 2 year follow up. Addition of arthroscopic debridement & chondroplasty to KJD makes it superior to KJD alone in terms of improvement in clinical,