My Equal-i-zer was pretty simple to set up and has never needed any adjustment since. As both my black and grey tanks are at the rear of the trailer, they can affect the tongue weight significantly, along with all kinds of other scenarios that do happen, none of which has even come close to requiring an adjustment. The head is the ONLY location for grease, and I have no problem staying clean while handling it. The onetime installation of the ball did require unique tools, but a shop did that for me for free. I marked the nut and threads so I can tell if it's loosened at all. But otherwise it's set it and forget it. A very nice feature is the fact that the bars don't even have to be removed from the head once you unhitch. They can just be pushed up under the bumper, where they will stay put. Certainly not a perfect hitch, but it does its job well. It can be noisy, no doubt.