INTRODUCTION: Despite the success of two-stage exchange total knee arthroplasties(TKAs), a subset of patients become reinfected and may be considered for a repeat two-stage exchange TKAs. A small, prior study from our institution demonstrated a 50% re-revision rate in such a cohort. The purpose of the present study was to evaluate a contemporary and larger cohort of repeat two-stage exchange TKAs with an emphasis on implant survivorship, risk factors, and clinical outcomes. METHODS: We retrospectively identified 87 repeat two-stage exchange TKAs performed between 2014 and 2021. The mean patient age was 66 years, 32% were women, and the mean body mass index(BMI) was 29. At the time of resection, 98% of patients were treated with a high-dose antibiotic spacer(58 non-articulating,27 articulating). The mean time from resection arthroplasty to reimplantation was 22 weeks. Kaplan-Meier survivorship analyses were performed, and risk factors(including the McPherson staging system) were assessed. The mean follow-up was five years(range,2 to 9). RESULTS: The 5-year survivorships free of re-revision for reinfection, any re-revision, and any reoperation were 88, 67, and 54%, respectively. Leading causes for re-revision were PJI (36%) and aseptic loosening(27%). There were no statistically significant independent risk factors identified. However, patients who had McPherson host grade C trended toward higher rates of reoperation(HR [hazard ratio] 2, P=0.057). Despite the high reoperation rate, at the final follow-up(mean five years), 91% of patients had a TKA in situ, 8% had been treated with above-knee amputation, and 1% with a definitive resection arthroplasty. CONCLUSION: Despite its challenges, including a 54% reoperation rate, repeat two-stage exchange TKAs may be considered in a subset of patients given 91% of patients had a TKA in situ at a mean of five years, and the 5-year survivorship free of re-revision for infection was 88%. Notably, patients who were McPherson host grade C trended towards failure.