I can see the advantage of retul for individuals who have various body difficulties.
For example cyclists whose legs are different lengths (we all have different length legs but those who go out of the comfort zone)
Or those whose feet are out of whack and twist the knee to either side in the pedaling motion.

Then again, many fitting problems are not fitting problems at all but rather a lack in cycling fitness (flexibility and core strength)
Also not sure about road pedals but spd's allow for enough float to reduce knee problems. So the cleat doesn't have to be half a degree accurately in the correct direction