Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2016; 7(12): 826-831
Published online Dec 18, 2016. doi: 10.5312/wjo.v7.i12.826
Effect of introducing an online system on the follow-up of elbow arthroplasty
Jetske Viveen, Ante Prkic, Bertram The, Koen L M Koenraadt, Denise Eygendaal
Jetske Viveen, Ante Prkic, Bertram The, Denise Eygendaal, Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, 4818 CK Breda, The Netherlands
Koen L M Koenraadt, Foundation for Orthopedic Research, Care & Education, Amphia Hospital, 4818 CK Breda, The Netherlands
Denise Eygendaal, Department of Orthopaedic Surgery, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, The Netherlands
Author contributions: Viveen J data collection and drafting the article; Prkic A drafting the article; The B critical revision of the article; Koenraadt KLM data analysis and interpretation and critical revision of the article; Eygendaal D critical revision of the article and final approval of the version to be published.
Institutional review board statement: The medical ethical committee waived ethical approval for the study as no new intervention or treatment was initiated.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jetske Viveen, MSc, Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Molengracht 21, 4818 CK Breda, The Netherlands. jetskeviveen@gmail.com
Telephone: +31-076-5955578 Fax: +31-076-5953819
Received: June 23, 2016
Peer-review started: June 27, 2016
First decision: August 11, 2016
Revised: August 22, 2016
Accepted: October 25, 2016
Article in press: October 27, 2016
Published online: December 18, 2016

To evaluate the effect of introducing a structured online follow-up system on the response rate.


Since June 2015 we have set up an electronic follow-up system for prosthesis in orthopedic patients. This system allows prospective data gathering using both online and paper questionnaires. In the past all patients received questionnaires on paper. This study includes only patients who received elbow arthroplasty. Response rates before and after introduction of the online database were compared. After the implementation, completeness of the questionnaires was compared between paper and digital versions. For both comparisons Fisher’s Exact tests were used.


A total of 233 patients were included in the study. With the introduction of this online follow-up system, the overall response rate increased from 49.8% to 91.6% (P < 0.01). The response rate of 92.0% in the paper group was comparable to 90.7% in the online group (P > 0.05). Paper questionnaires had a completeness of 54.4%, which was lower compared to the online questionnaires where we reached full completeness (P < 0.01). Furthermore, non-responders proved to be younger with a mean age of 52 years compared to a mean age 62 years of responders (P < 0.05).


The use of a structured online follow-up system increased the response rate. Moreover, online questionnaires are more complete than paper questionnaires.

Keywords: Patient reported outcome measures, Elbow, Follow-up, Arthroplasty, Online, Database

Core tip: Since the last decade, increasing attention is paid on patient reported outcome measures (PROMs) and several online follow-up systems became available to collect PROMs. The purpose of this article was to evaluate the introduction of a structured online follow-up system in order to facilitate analysis of data.