Forced toe-in hurts my knees. IOW, we are each individuals. I like pinned flat pedals with Five Ten shoes because I my left knee sometimes hurts when my foot is in one position, sometimes in another. Also, the pins keep the rubber soled shoes in a single position on the pedals, and the flats (without toe clips) make mid-foot pedaling easy to do. When my knee hurts, I can adjust my foot to a position in which it doesn't hurt.
...Just another option for you to consider. I'm 77 and overweight with osteo-arthritis, especially in left knee and right hip, and 3 surgeries so far (thumbs and shoulder replacement)