No, the extensions (ram-handler, console.device etc.) are being loaded with exec44. I'm using blizkick for this anyway, not the setpatch command.
One of the incompatibilities that comes to mind right now (they are not many) is the daterecall utility: It crashes with exec44 but runs ok with 3.0, 3.1 and 3.9 exec libraries.
So, you do have OS3.9 but you prefer to install exec44 instead, because it's faster, right?