Threaded MPMs and PHP work quite well, I fixed a few bugs in that space some time ago.
There however might be issues in some of the millions libraries PHP potentially links in an called from it's extensions, and those sometimes at emit thread safe, but finding that and finding bypasses isn't easy ...
The other issue is that it's often slower (while there recently were changes from custom thread local storage to more modern one) and if there is a crash (i.e. Recursion stack overflow ...) it affects all requests in that process, not only the one.