Definitely. I'm toying with the idea now, perhaps for my Dereg sheath. It's not too bad, but the stock sheath rattles a bit with the knife in place. Gotta figure out how to secure it inside the sheath though, I'd rather not glue it.
I suppose I could install a grommet into the sheath and run a screw through a retention hole like on the above design, but that would limit the direction of carry, I would think... Hrm.... decisions decisions!
If you want a tight fit, it HAS to limit direction of carry. But even then...you could still mount it on molle, or wear it weak side...just that the blade has to maintain same orientation relative to the sheath.