Standard TTA plates rely on a barbed fork system for attachment onto the tibial crest. Many surgeons consider that the hardest part of the TTA procedure is preparing for and placing the fork. Forkless TTA plates are screwed onto the tibial crest using 2.4mm screws. The distal part of the forkless plate is secured using 2.7mm or 3.5mm screws as appropriate. The rest of the procedure is as per the standard technique.