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It screws up caster and toe too. The truck will be all over the place if you have one worn out bad. It can also cause an uncontrolled vehicle if you hit a bump in the road at any speed. That happened to me a couple months ago when I was loaded down with a full and very large horse trailer. My front spring bushings were shot and I knew it and when I hit the bump the suspension bottomed out hard and the truck flew right off the road.
The very next day all of my springs got rearched, bushings and shackles replaced and I realigned it when I got it home. It's much safer now.
Its a PITA. They are pressed in but not usually extremely tight. Careful work with a air hammer will get them out. There is a special tool that makes quick work of installing them if you can find it but I use a air hammer with a flat hammer attachment to install them.
Dana 60 swaps are nice, but not all of us have a extra $1000 sitting around to do it. I have two trucks with TTB front ends and have no problems with them but someday will put a dana 60 in the 94