Rock Band's core game logic is fairly well decoupled from frame rate for the most part, actually. I usually run Rock Band 3 (with a fan mod called RB3 Deluxe installed) on an emulated PS3 at 75Hz and it runs perfectly. The only real issue is certain venue post processing effects behave weirdly at high frame rates (like the handheld camera shake effect) but with the aforementioned mod we can disable that.
But modern displays add unnecessary latency on top of that. HDTV CRTs often did too. Input devices sometimes add latency too. It's really not too awful as long as it's consistent, real musical instruments have latency too (especially pipe organs! but organists manage to figure it out). It's not as much fun if you need to hit the note when it's visibly far from the 'goal' section, or if the judging becomes visible a long time after the note --- shortening the feedback loop is good.