I have 10K miles on my truck since installing the spacers and my ball joints are as good as new. I installed good quality ball joints (Moog) that are grease-able, and use a high quality synthetic grease every oil change. With only 2” of strut lift the ball joint and CV joint angles are not that severe, and even on the trails I’ve never hit the struts with the upper arms.
The BTF arms are quality units, nothing but good reviews here, if you ‘need’ them is dependent on how much lift and how much extreme off road use the truck sees. Anything over 2” of strut spacer lift in the front and you should use the BTF arms due to the ball joint angle for reliability. If you plan to do a lot of extreme off road flexing, the BTF arms should be used with any spacer lift.
My Ex only sees occasional ‘moderate’ off-road action, mostly state forest access roads, and small mud-pits, and I drive responsibility while off road. The factory arms are working just fine for me.
Yes, my front suspension squeaks a bit, but I believe it’s the lower control arm bushings.
Hope this helps.