At present, computer assisted surgery systems help orthopaedic surgeons both plan and perform surgical procedures. To enable these systems to function, it is crucial to have at one's disposal 3D models of anatomical structures, surgical tools and prostheses (if required). This paper analyses and compares three methods for generating 3D digital models of anatomical structures starting from X-ray images: parametric solid modelling/reconfiguration, global shape modelling and free-form deformation. Seven experiences involving the generation of a femur model were conducted by software developers and different skilled users. These experiences are described in detail and compared at different stages and from different points of view.