Match the start of the string up to the first ? and use a (*SKIP)(*F) to omit the first match:
$str = 'www.domain.com?adult=2&airport=40-48?destination=recko';        
echo preg_replace('/^[^?]*\?(*SKIP)(*F)|[?]/', '&', $str );
// => www.domain.com?adult=2&airport=40-48&destination=recko
See the IDEONE demo
Pattern details:
- ^- start of a string
- [^?]*- 0+ characters other than- ?as many as possible
- \?- a literal- ?
- (*SKIP)(*F)- two PCRE verbs making the regex engine omit the text matched so far in the current iteration
- |- or
- [?]- a literal- ?
Alternative to (*SKIP)(*FAIL) is to use preg_replace_callback and the former pattern with the first alternative branch inside capturing parentheses:
$str = 'www.domain.com?adult=2&airport=40-48?destination=recko';        
echo preg_replace_callback('/^([^?]*[?])|[?]/', function($m) {
    return !empty($m[1]) ? $m[1] : "&";
}, $str );
See this IDEONE demo
The ^([^?]*[?]) part matches the string part from the start will the first ? and places into Group 1. Inside the anonymous method where we pass the match object ($m), we can check if the group matched ("participated in the match") with the help of !empty($m[1]). If it is, we just put it back. If not, the [?], the second branch matched, so, we replace it.