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Transtibial pullout repair is increasingly being utilized for repair of meniscal root tears. Loosening and suture pullout may occur after such a repair but has not been reported in the radiology literature. We present a case of a transtibial pullout repair complicated by suture pullout, recognized on MRI and confirmed on subsequent arthroscopy. This complication may occur in the immediate postoperative period and is important to recognize as it requires surgical management., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)