A computer implemented system for adjusting the placement of an implant in a patient through the use of a dimensioned grid template placed relative to patient anatomy on a fluoroscopic machine and a method to digitally quantify alignment parameters is provided. This system can be used for determining: 1) leg length, offset, and cup position during arthroplasty replacement surgery; 2) fracture reduction/correction position during trauma procedures and 3) an apparatus to be used for deformity correction planning is provided; 4) placement and positioning of instruments and implants relative to bone and anatomical architecture; 5) bone anatomy boundary parameter identification relative to reaming and cutting landmarks of bone.