24 patients undergoing foot and ankle arthrodesis surgery were randomized to receive either an autogenous bone graft or B2A-coated ceramic granules. The purpose of this pilot study was to compare the safety and efficacy of each treatment, and determine the feasibility for a larger scale, statistically powered, randomized controlled trial (RCT). Radiographic assessments performed at 6 months demonstrated similar fusion success between groups, at 9 months fusion success was 12/12 in the B2A group and 8/12 in the autograft group. Furthermore, from baseline to 12 months pain and disability Ankle Osteoarthritis Scale (AOS) scores improved similarly, and there were no adverse events related to the graft material reported by any patients. It should be noted that this study was under-powered to detect significant differences between groups.