AIM To evaluate the effect of introducing a structured online follow-up system on the response rate.METHODS Since June 2015 we have set up an electronic followup 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.RESULTS 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).CONCLUSION The use of a structured online follow-up system increased the response rate.Moreover,online questionnaires are more complete than paper questionnaires.