Do these use the factory ball joints, or do they come assembled?

Control arm assembly configuration is not specified — verify whether your truck uses pressed or bolt-on ball joints before install. Have your old arms on hand to compare during fitment.

Will I need to get an alignment after installing these?

Yes. Any front suspension component replacement disturbs wheel alignment. Plan for a full front-end alignment at a shop with RAM-specific alignment specs.

Can I use these arms with my existing ball joints and bushings, or do they need to be replaced?

Reusing old ball joints and bushings is possible depending on their wear. If your truck has high mileage or worn suspension, replacing worn components at the same time prevents premature wear on the new arms. Inspect the old hardware when you remove the factory arms.