The only serious user of rt-linux which uses it to build a hard-RT system that I know is SpaceX. Look up the Reddit AMA post from them on how rt-linux is used. They are staying on a specific kernel version, had to do kernel patches (other than applying rt-linux), they use a very specific model of an old Xeon for low latency interrupts, incorrect programming of one process can disrupt the RT behaviour of another process, and most importantly, they have a secondary board, a truly real time one (PowerPC based, IIRC) to communicate with the real hardware.