When athletic-minded Emily Potthast tore her anterior cruciate ligament — or ACL — in her right knee, she feared her high school athletic career might be ended.

“I was coming down from a rebound; there was no contact or anything,” she said. “It just tore. I immediately fell to the ground. It was the worst pain of my life.”

It happened during a summer league basketball game. She damaged her ACL and her meniscus — part of the connective mechanism that helps the knee operate.

It was July 2009. She was about to enter her senior year playing basketball and volleyball for Marquette High School. She also played other sports year round, so the thought of being benched was horrible.

“I was in shock,” she said. “I never thought about it being torn.

“The first thing I asked my doctor, was I going to be able to play again, my senior year, that was my biggest concern.”

The history of what ACL injuries do to athletic careers, pro and amateur, has been pretty bleak. Athletes routinely are sidelined several months or even permanently. New England Patriots quarterback Tom Brady missed most of the 2008 NFL season with an ACL injury.

“The surgery used to leave a 10-inch gash along the side of the leg, days in the hospital, then a cast for two months,” said Dr. Michael Milne, the orthopedic surgeon and sports medicine physician who helped Potthast. Six to eight months later an athlete might continue playing, he said.

It was no comfort to Potthast to learn that women athletes are up to four times more likely than men to suffer ACL injuries.

There’s plenty of speculation as to why, Milne said.

Women start training later for sports, women’s joint physiology isn’t as compatible with impact sports as men’s, hormones, skill, but no one really knows, he said.

What is known is that basketball, volleyball and soccer, in that order, account for the most ACL injuries among women athletes, and 80 percent don’t involve contact — just landing the wrong way or taking a step at the wrong angle, he said.

Potthast wanted to be ready for basketball tryouts at the first of the school year and be ready to play in October.

She consented to a relatively new type of surgery that involved small holes in her knee and a fast recovery time.

October arrived and the 6-foot forward returned to the court to finish her high school career.

“It was like nothing had happened,” she said. “Even the scar was so small you could hardly see it. I’m a girl and the scar really mattered.”

Potthast’s surgery was a procedure called the AperFix System.

BY HARRY JACKSON JR. • harry.jackson@post-dispatch.com > 314-340-8234