Miltonias can be a bit fussy with repotting, but if the current medium isn’t great or the roots are getting cramped, you should be fine. Best time is usually when new growth just starts, but if it’s already a bit along, it’s still doable—just be gentle.
Lava rock in semi-hydro can work, but Miltonias like moisture with good airflow, so just make sure it doesn’t stay too wet. If you go for it, keep an eye on watering and humidity until it settles in
