At an average follow-up of 5.3 years, the failure rate was 23.86% (21/88 knees) in the F-DAIR group and 15.62% (15/96) in the direct 2-stage revision group. Prior F-DAIR procedure was associated with approximately twice the risk of failure compared to direct 2-stage surgery (hazards ratio 1.94, 95% confidence interval 1.01-3.714, P = .047). Excluding PJIs caused by methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, and Pseudomonas from analysis revealed similar failure rates between the 2 groups. The Knee Society Clinical Score, Knee Society Functional Score, and final range of motion at final follow-up were lower in the F-DAIR group. Incidence of culture negativity and infection with resistant organisms was higher in the F-DAIR group. The rates of eradication of methicillin-resistant Staphylococcus aureus and Pseudomonas infection were much lower in the F-DAIR group.