Knot concordance in homology cobordisms

Let $\widehat{\mathcal{C}}_{\mathbb{Z}}$ denote the group of knots in homology spheres that bound homology balls, modulo smooth concordance in homology cobordisms. Answering a question of Matsumoto, the second author previously showed that the natural map from the smooth knot concordance group $\mathcal{C}$ to $\widehat{\mathcal{C}}_{\mathbb{Z}}$ is not surjective. Using tools from Heegaard Floer homology, we show that the cokernel of this map, which can be understood as the non-locally-flat piecewise-linear concordance group, is infinitely generated and contains elements of infinite order.